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Hospitals to face financial penalties for readmitting patients


Hospitals will face financial penalties if patients are readmitted as an emergency within 30 days of being discharged, under government plans to be announced today.

Hospitals will get paid for initial treatment but will not be paid again if a patient is brought back in with a related problem, health secretary Andrew Lansley will say.

It has been argued that some patients are discharged too soon and without proper care plans in place.

The Conservatives have also said cuts to the number of hospital beds under Labour put pressure on NHS staff to discharge people without support.

Between 1998-99 and 2007-08, the number of emergency readmissions in England rose 52% from 359,719 to 546,354.

Speaking about his vision for the NHS, Mr Lansley will call for patients to be given more control over their health.

He will call for a greater focus on outcomes for patients and for the NHS to listen to what people want.

“We will empower patients as well as health professionals. We will disempower the hierarchy and the bureaucracy,” he will say.

“I want the service to listen to patients, to take responsibility. To realise how much patients know about their need, especially for those living with long-term conditions.

“To give patients and care users more control, exercising choices, through to personal budgets.

“To empower patients collectively, through patient representative groups, impacting on the quality standards and commissioning guidelines, through to patients and the public locally, impacting on decision about access and designing of local services to meet local needs.”

Mr Lansley will say that targets focused on processes, data returns and more Department of Health circulars will not achieve these aims.

Neither will “pointless structural upheavals or increasing the number of administrators in primary care trusts, nor even just by supplying more money”, he will say during a speech in east London.


Readers' comments (9)

  • Smoke and mirrors. Exactly how will this work and how quickly will hospital managers work out a way of managing the data to say what thewy need it to say. More paperwork!

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  • Dear Andrew, Have you any idea how chronic health problems progress?
    Lets hope our patients are not too scared that the care they receive will be of a lesser standard because the hospital are not being paid !! after all it will not be their fault if they are readmitted within 30 days of discharge, chronic diseases do not manifest to a time slot, this will instill fear amongst vunerable people,

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  • Seems a little harsh, for example, the patient admitted with exacerbation of COPD is likely to have frequent, repeated admissions with exactly the same problems. Most of these patients are already under community matrons at home to prevent re-admission anyway. Just what will this achieve? In some cases, with some long term conditions, frequent admission is just part and parcel of the illness itself. And what about the frequent flyers that we are all aware of? Those whose personal circumstances mean that they know all the tricks to get themselves admitted to hospital even when medically speaking they don't need it? This is an ill thought out policy and instead of preventing an early discharge will mean that people who really need admission will be turned away in A+E because they are within the 30 day period

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  • Hello Andrew,

    It is very disappointed for patients who are having long term diseases. It seems that they have to manage their conditions or if they are readmitted in the hospital within the 30 days, it is unfair for the carers to provide adequate care and they may think that they are not going to be paid for that. Andrew I think you should look at this closely as it will put alot of pressure on the NHS staff including reducing the staff. Previously they has been alot of neglience with good pay but what about when every staff is threatened as funds may not be enough. This is therefore unfair for the NHS staff and the vulnerable patients who need A & E services.

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  • So another 'target'? Have they ever wondered exactly why patients are re-admitted within 30 days? I seriously question the thought process of those who sit around number crunching the beds & seeing only numbers not actual living, breathing, thinking ill patients, who do not choose to use a hospital bed but unfortunately 'need' it. False economy of rushing them through the doors?

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  • Seems like a good idea, given the huge increase in numbers readmitted (unplanned) within 30 days of discharge. Hopefully it will persuade hospitals to invest in pre-admission and post discharge services, which are, in many areas, desperately lacking.

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  • In my experience we are sending elderly people home to circumstances that often will lead to readmission. Similarly it appears that GP's often resort to an admission when the "care" at home is not really working any more.

    Can we not encourage families to take more responsibility for actively looking at care before things become an emergency and also stop the infighting about budgets between NHS and Social Services that seem to leave the poor patients as piggy in the middle.

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  • I know Long Term conditions has been mentioned but how will this policy affect situations as people who take over doses? At my hospital we have OD patients who are discharged as medically fit & deemed to be able to make their own decisions; however are often readmitted via A&E within this 30 day limit.

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  • Andrew Lansley has a lot of ideas, however I wonder who came up with them and how well they were thought through.
    The hospital is not responsible for all readmission post surgery. Some reasons are community based, perhaps he should be talking to people who actual work on 'the shop floor' in the NHS.
    We have a robust pre-op and discharge system in place, however a few patients need to spend time in rehab / community hospital post surgery, not in an acute hospital, prior to going home, where is the money and ideas to ensure this is in place. Some of his other ideas area already in place in his constiteuncy perhaps he should ask people there for help.

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