This is onmedica -
All hospitals ordered to review overnight discharge policy
Caroline White
Tuesday, 17 April 2012
The medical director of the NHS has ordered an urgent review of hospital discharge practice following revelations that potentially hundreds of thousands of vulnerable patients are being discharged at night to free up beds.
The medical director of the NHS has ordered an urgent review of hospital discharge practice following revelations that potentially hundreds of thousands of vulnerable patients are being discharged at night to free up beds.
Professor Sir Bruce Keogh has written to strategic health authority medical directors, to tell them that discharging elderly patients between 11 pm and 6 am to make their own way home is “obviously unacceptable, and need[s] to be addressed urgently.”
The letter follows the publication by The Times of figures it had obtained under a Freedom of Information request. These showed that 293,000 patients at 100 hospital trusts had been sent home between 11pm and 6am last year.
While these figures account for just 3.5% of all discharges and have not changed in five years, it could nevertheless mean that 400,000 such discharges are being made every year at all 170 hospital trusts, equivalent to almost 8,000 a week.
The figures have provoked outrage and a slew of negative media headlines.
In his letter, Professor Keogh points out that NHS trusts seem to have included self-discharges, deaths and discharges, and patients in assessment units in their responses, while others focused on discharges only, so the true picture may not be as bad as it first appears. Nevertheless, hospitals should take stock, he says.
“Whilst these different approaches make 'like for like' comparisons of this particular set of data difficult, the challenge to the NHS is absolutely clear - that patients should only be discharged when it is clinically appropriate, safe and convenient for them and their families,” he writes.
He has demanded that all trusts, including those that did not respond to the FOI request, review their figures and make the results available by the first week of May.
“It is important that Trust Boards take ownership of this issue, so I would expect Medical Directors, working with their Nursing Director colleagues, to ensure that the findings of their reviews are reported to their Boards at the earliest opportunity,” writes Professor Keogh.
“As health professionals we all agree that patients should be treated with compassion, so it is simply not acceptable to send people home from hospital late at night when they may have no family members nearby to support them,” he adds.
“I would like your assurance that appropriate arrangements are in place in all NHS Trusts to ensure timely discharge and care transfer for all patients, and I expect to discuss the outcome of the actions I have requested when we next meet on 8 May,” he concludes.
A year on, and it's still going on..?
And they want to trust these people with running a death pathway!
This is Mail Online -
Hospital patient discharged at 3.30am without a coat in sub-zero temperatures is found 'tearful, frozen and wandering the streets' by police
- Michael Atkinson, 64, was discharged by the Royal Bolton Hospital at 3.30am
- He was confused and was found an hour later by police tearful and freezing
- He was wearing a hospital wristband bearing the name of a two-year-old girl
- The hospital is investigating but his wife, Helen, wants to take legal action
- At least two other similar cases have emerged recently at the same hospital
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A hospital investigation has been launched after a confused patient was discharged at 3.30am without a coat in sub-zero temperatures.
Michael Atkinson, 64, was discharged from the Royal Bolton Hospital in Greater Manchester before being found by police tearful, frozen and wandering the streets more than half a mile away.
He had hurt himself after he fell while he was lost and was ‘very distressed’ by his ordeal.
He was also wearing a hospital wristband bearing the name and details of a two-year-old girl.
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| Michael Atkinson, 64, was discharged from the troubled Royal Bolton Hospital in Greater Manchester before being found by police tearful, frozen and wandering the streets more than half a mile away |
Earlier this month, Jonathan Hastilow-Sands, a 90-year-old Alzheimer’s sufferer, was reported missing from the same hospital. He was discovered in Bristol, 175 miles away.
This week it was also revealed that an unnamed 76-year-old male patient walked more than a mile from the hospital in his pyjamas and dressing gown before he was stopped and taken in by a hairdresser.
Hospital bosses have now launched a ‘full review’ into what happened to Mr Atkinson on March 6.
His wife, Helen, who had been told her husband was being admitted to the hospital for a brain scan following a stroke, is also calling for action to be taken against the hospital for ‘negligence’.
Mrs Atkinson, from Breightmet, Bolton, said: ‘When the police brought him back, he was in a terrible state. I was distraught and he was crying. He was like a bag of ice. It has made him worse.
‘Something is very wrong at that hospital. You don’t discharge a man in his state at 3.30am.’
She has told how she called the hospital to find out why she had not been contacted to collect him and said she was told they ‘couldn’t find my number in his notes’ and that her husband could not remember his phone number.
Mr Atkinson suffered a stroke in 2005 and has been taking morphine for a slipped disc that has trapped a nerve.
He suffers from emphysema and lung disease and has had pneumonia three times.
Mrs Atkinson said her husband had been due to be collected by an ambulance for a brain scan, following a possible second stroke, between 3.30pm and 7.30pm on March 5.
However, an ambulance did not arrive at the couple’s home until 11.40pm that night.
Mrs Atkinson said the ambulance staff did not know why they were collecting her husband and, when at the hospital, no scan was carried out.
After her husband was brought home by police at 4.30am the next morning, the 64-year-old said she was ‘livid’.
He was found without his coat, which had been a Christmas present, and was missing his medication.
Mrs Atkinson believes if he had not been found he could have got hypothermia and died.
Mr Atkinson was re-admitted to the Royal Bolton Hospital for treatment, but has since been discharged and is back at the couple’s home.
His wife has complained to the hospital and has contacted solicitors.
She said: ‘I am so upset that my poor husband has suffered for so long unnecessarily. It is disgusting.
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| he hospital says that it is carrying out an investigation into what happened |
‘Every time I walked in there to go and see him I took notes because I don’t trust them.’
Heather Edwards, head of communications at Bolton NHS Foundation Trust, said: ‘We are aware of Mrs Atkinson’s concerns and a full review is taking place to understand exactly what happened.’
Last year hospitals were told to end the ‘obviously unacceptable’ practice of sending elderly or vulnerable patients home in the middle of the night.
Sir Bruce Keogh, medical director of the NHS, ordered an urgent review of how the service is discharging hundreds of thousands of patients amid concerns some are being left to fend for themselves.
His intervention came after The Times newspaper obtained figures showing 293,000 patients at 100 hospital trusts had been sent home between 11pm and 6am in 2011.
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