A “chronic” dearth of hospital beds that led to an elderly patient’s surgery getting cancelled four times could be alleviated with the help of nursing homes.

That is according to two sources familiar with discussions between an elder care facility and the Bermuda Hospitals Board.

The two, speaking on condition of anonymity, said the BHB had been receptive to the use of nursing homes to free up space.

However, they said, the discussions had failed to advance into action over much of this year.

“The chronic shortage of beds in the hospital has been a problem since the construction of the new acute care wing — it’s worse at times than others, but it’s a longstanding issue,” one told The Royal Gazette.

“There is an opportunity to shift some long-term elderly patients to seniors’ homes and make space.”

The two said talks between the BHB and a prominent seniors’ home had gone on for “months” without gaining traction.

Keeping an elderly patient in care long term at the hospital was said to cost roughly $30,000 a month, whereas a nursing home could perform the same function for nearly one-third the cost.

“The thing that’s strange is we have this very public problem with the hospital, but for the people responsible for making this decision it seems there’s no urgency.”

Problems with “bed blocking”, particularly when families failed to collect family members from the hospital when they were ready to be discharged, were highlighted in May after an elderly patient waited 56 hours for a bed after being admitted to King Edward VII Memorial Hospital’s emergency department.

The source who spoke recently with the Gazette said they had an elderly relative with a heart condition whose gallbladder surgery had been called off abruptly four times because there was no space available for post-operative care.

In one case, the man was in the hospital and gowned up for surgery at 11am, waiting to be operated upon, when the physician informed him it had been cancelled.

When the fourth appointed surgery was cancelled in September, all elective surgeries that day were said to be unable to proceed.

Describing the procedure as “not dire, but a necessary operation”, the source said repeatedly calling off a surgical procedure aggravated an already difficult situation.

“He has had some stress because of this. But it causes stress through the rest of the family. I think it has a ripple effect that is not positive.

“If you’re constantly having it cancelled, it’s not good for the patient or the surgeon and their team.

“The mantra is that the community is not picking up people when they’re supposed to be discharged. It’s a pervasive issue for the hospital. It’s about having the capacity to schedule people for elective surgeries.”

The BHB cannot comment on individual cases but a spokeswoman said: “We are very sorry for the cancelled surgery and apologise to the patient concerned.

“We understand how challenging and frustrating it is for a late cancellation. We do everything we can right up to the surgery time to make it happen, but must ensure the safety of the patient post-surgery as our priority.”

The BHB carries out roughly 700 surgeries a month, the spokeswoman said.

“The range of cancelled surgeries per month since January 2023 due to no hospital bed ranges from one per month to a high of seven per month, which translates to an average of three or four a month.”

The spokeswoman said that while general hospital beds might be available, in post-surgery cases “a specific type of bed with telemetry is needed due to either the type of surgery or the health of the patient”.

“Surgeons hold their own individual wait lists. BHB is given the list of booked surgeries two weeks ahead of time by the surgeon’s office, so we do not know how many people are on the private lists.

“BHB does need people to pick up their loved ones when they are ready for discharge, or work with us and other agencies if preparations are needed at home.

“This has a huge impact on our ability to ensure we have capacity for new patients coming from emergency and same-day admission surgeries.”

The spokeswoman did not comment on discussions with any elder care facility to ease pressure on the hospital.

However, she said: “We work with all the local nursing homes, but discharges to nursing homes are also complex — it is not just available placements, but whether there is the appropriate level of care, and family preferences and finances all impact such a transfer.”

In a comment sent last week to the Gazette, the spokeswoman said there were “about 27 people in the hospital who no longer need hospital care”.

The figure was said to be roughly equivalent to an entire ward.

The spokeswoman added: “It would be very expensive to Bermuda for BHB simply to add more acute care beds for people who do not need acute care services and could be cared for at home or in lower-cost facilities.”