By Ryan Gilkes
Saddled with delays in patient care amid rising demand and Barbadians leaving their elderly relatives at the Queen Elizabeth Hospital (QEH), the director of medical services said it is hoped that in a couple of months, a “fully expanded” emergency care system will be more efficient and responsive.
Anthony Harris also gave an assurance that the island’s premier acute care hospital is committed to providing quality care to the people. He said the challenges faced by the Accident and Emergency Department (AED) are expected to ease after its full expansion, scheduled for March.
There have been mounting criticisms and complaints about service levels at the hospital, particularly in the AED which has been saddled with patient delays.
“There is certainly a greater demand for the use of Accident and Emergency here, and emergency rooms in general worldwide, so we are not an exception in that case,” Harris told Barbados TODAY. “Added to that, we are still right now a construction zone… so we are at half the capacity we will be in two months. That is the reality, and we always have to keep [in mind] that that is what is happening as well. It is a gross inconvenience to the Barbadian public and it is also a gross inconvenience for the people trying to work there.
“We are hoping that with the fully expanded A&E, we will be able to provide some ease for patients and some ease for us, because the flow should get better and if we believe the maxim that function will follow form, we are expecting that we will see some improvement. We are not going to be naive to think that this will solve all of the problems, because all are not in the AED itself but also on the wards.”
The hospital opened in 1964 with over 460 beds and has expanded to accommodate over 600 beds. But Harris highlighted the strain on resources, with each ward currently housing between 20 and 24 beds and a significant number of elderly-for-care patients, which presents complex challenges. Currently, there are close to 50 elderly for-care patients at the hospital.
“We got some out over the last few days, but we were running 48 elderly-for-care in the hospital which is two full wards,” Harris explained.
The term “elderly-for-care” refers to patients cleared for discharge but who require 24-hour care and whose families may lack the resources or time to provide adequate care at home. Harris said while the term does not serve as a medical diagnosis, it points to the difficulties families face in caring for elderly relatives, particularly those with chronic illnesses like heart failure, diabetes, kidney failure, or end-stage cancer.
“This term, elderly-for-care, is unfortunate because what it says is you get old and the country and family are no longer able to take care of you outside of this institution. [But] let us be absolutely fair – old people require 24-hour care, and it’s very hard for a family to do if they need to be working. That’s a reality, so we need good social services,” he said.
“It is not a simple fix, it is not a simple finger-point that you can say you are abandoning your granny here and stuff, There are some things like that but at the root of the problem, it is also a lack of resources by some families . . . and they don’t have to be poor to have lack of resources; it can be because [of] a lack of time.”
To alleviate pressure on the A&E, Harris encouraged the public to use the Patient Advice and Liaison Service (PALS/Help Desk), which operates for 15 hours, providing immediate medical advice, categorising cases, and connecting callers with appropriate healthcare providers
He emphasised that this service does not deny access to healthcare but rather guides individuals on how to use the system effectively, suggesting appropriate care and advising on whether immediate AED attendance is necessary.
“They can call and discuss and we will guide,” the QEH medical services director said. “We are not out there saying do not come to the Queen Elizabeth Hospital, you’re on your own. We are certainly providing that support to the public. Some people have used it and I think it is a service that is underutilised but certainly a very valuable service to the public that they can call and get advice.
“And the advice perhaps is ‘maybe you don’t need to come to the AED tonight at 8 o’clock, perhaps you can seek care in the morning. If there are any further problems in the night, please call back’. I don’t think [with this service] we are denying persons physical access to doctors or immediate health care. I think what we are doing, and I would hope that they see it that way, is offering advice on how to use the system better.”
Harris highlighted plans to evolve this service to make it more personalised and efficient, drawing inspiration from similar systems like Britain’s NHS Direct.
“It is not a Queen Elizabeth Hospital original. The National Health Service of Great Britain has a similar service which is called NHS Direct which is just that – a Help Desk situation, but right across their network. They have boasted that it has boosted efficiency. We are beginning to explore how this would be introduced, utilised and developed in Barbados,” he said.
(RG)
