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NHS director pledges action on overnight discharging


The medical director of the NHS has promised action after it was reported that hundreds of thousands of patients are being sent home from hospital in the middle of the night to relieve pressure on beds.

Some 3.5% of all hospital discharges took place between 11pm and 6am, a rate that has held steady for the last five years, according to The Times.

The newspaper submitted Freedom of Information requests to all 170 hospital trusts in England, asking for details of patients discharged between those hours.

Some 100 trusts responded, saying that 239,233 patients had been sent home at that time last year.

If all other trusts were discharging at similar rates, this would add up to 400,000 such discharges every year, almost 8,000 a week.

Rates varied between 8.7% and less than 1% across the trusts, the newspaper said.

It quoted patient campaigners saying that the elderly were often worst affected as they are abruptly sent home to empty houses without proper planning.

Sir Bruce Keogh, medical director of the NHS, said: “I am concerned to hear that some patients may be being discharged unnecessarily late.

“Patients should only be discharged when it’s clinically appropriate, safe and convenient for them and their families.

“It is simply not fair to be sending people home late at night. We will look at this.”



Readers' comments (12)

  • What action will be taken?
    Trusts will probably be instructed to fiddle the statistics and hide the fact that elderly and vulnerable people are being sent home in the middle of the night, the majority of which are left to find their own way home to cold houses.

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  • unbelievable, inhumane and potentially unsafe, and anxiety provoking for many.

    the sooner we have the return of clinical managers to run our health services the better.

    don't people understand that sick people and those who have had a period of hospitalisation are far more vulnerable.

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  • tinkerbell

    unethical and cruel.

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  • P Rogers

    All of the above contributions are of course true, but do we think it’s a bit of a shame that it’s the head medic who’s fronting up the response to this?

    Not a squeak out of the CNO the professional leader of the legion of “Directors of Nursing & Patient Experience, Deputy Chief Exec/COO/DIPC etc etc’. Perhaps it’s because even the mandarins in the DH know you’re far more likely to meet a senior doctor in an NHS hospital between 6pm and 8am than an ‘Executive Nurse’ or even a Matron!

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  • P Rogers | 12-Apr-2012 9:52 pm

    surely it doesn't matter who is involved as long as the right patient outcome is achieved.

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  • as if discharging at this hour wasnt enough what about the 80 and 90 year old patients being awakened inthe early hours to move wards and even other hospitals to allow patients from ED to aquire a bed

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  • I don't get this but I am interested at the way the article is spun:
    "it was reported that hundreds of thousands of patients...."
    That's 2.4 hundreds of thousands just for accuracy.

    Patients are admitted throughout the 24 hour period, we operate a 24 hour service and the sad fact of life is that a quart does not fit into a pint pot. Of course effective discharge planning would mean that the vast majority of patients would be discharged during more social hours - oh hang on..... more spin has clouded the facts but 96.5% of patients are in fact discharged during more acceptable times of the day. Has this article been deliberately spun to create a mountain out of a molehill? It looks that way to me.

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  • An equally big story should be why 70 of the 170 Trusts who were sent a FOI request have broken the law and not responded.

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  • OK - in twenty years of nursing on the wards the only patients I sent home at night were the ones who wanted to self discharge and were in a fit state of body and mind to do so. I have held patients in hospital who were so unwell but determined to discharge themselves (one phoned the police) on consultant orders.

    No where in this report does it mention how old the patients are, what was wrong with them, what time they were ready to go and what time the family actually collected them! This is a very damaging report which does not appear to show many of the actual facts surrounding the figures. We are not allowed to hold people against their will without a section or if the patient is so confused they are likely to cause themselved more harm.

    The report only suggests this would be awful to elderly people being kicked out in the middle of the night but does not actually have any evidence of this. The FOI only gives the bare minimum to protect patient rights as per the Caldecott protocols

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  • Does anyone know how many of these patients were already deemed fit for discharge but for some reason or another didn't go home during the day and the reasons why.

    How many of these patients were directly discharged from A&E?

    How many self-discharged?

    How would people feel if they or their relatives couldn't be admitted because the hospital was full? Is it morally right to keep a patient in hospital, deemed fit for discharge, because the relatives are going out for the evening or refuse to pay for a taxi to take them home.

    If 'reports' like this are going to be published they should at least be totally honest and a lot more in depth.

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