NHS orders review of “unacceptable” patient discharges

Following figures released concerning the overnight discharge of vulnerable patients on the NHS, Sir Bruce Keogh, the medical director for the National Health Service, has stepped in and ordered a review of the service. The information shows that in 2011, 293,000 patients in 100 hospital trusts had been sent home between the hours of 11pm and 6am. With all other trusts taken into account, estimates put the potential number at around 400,000, which breaks down into an average of almost 8,000 patient discharges a week. Hospitals in Derby, the Midlands and Chester came out with the highest percentage of overnight discharges. 

In a letter addressed to medical directors in the Strategic Health Authorities (SHA), Keogh emphasised the “unacceptable” examples of sending the elderly and vulnerable home late at night, stressing that their practices “need to be addressed urgently”.

He has ordered an urgent review amid concerns as to the welfare of vulnerable patients and the worry that they are being left to fend for themselves after being expelled from hospitals. “We all agree that patients should be treated with compassion, so it is simply not acceptable to send them home when they may have no family members nearby to support them,” he said.

Chief executive of The Patients Association Katherine Murphy echoed this, questioning “is it convenient and safe for a patient to go home without any warning…? How ‘patient-centred’ is this?” 

Keogh’s warning came as David Cameron prepared to meet with a panel of nurses, patient and medical experts over other concerns about patient care in the NHS system. Evidence last year from the Care Quality Commission (the NHS watchdog) indicated that 20% of hospitals were breaking the law concerning elderly patients, while 40% did not offer appropriate and respectful care. He discussed the treatment of patients, improving patient trust and restoring a sense of pride to the nursing profession.   

Keogh will meet with the SHA medical directors next month to track the progress being made. David Stout, deputy chief executive of the NHS Confederation, which represents NHS managers said, “what is critical is making sure hospitals are confident that their arrangements for discharging patients and getting them home are both appropriate and safe.”

Sophie Mihell-Hale