Deaths of three older people trigger safety doubts over discharge policy

Bournemouth Council is reviewing the deaths of three older people
who were readmitted to hospital shortly after being discharged into
the community.

The three people died in the Royal Bournemouth Hospital soon after
being readmitted. The case has raised concerns that the delayed
discharge reimbursement system could be resulting in particularly
frail older people being discharged from hospital inappropriately,
although Bournemouth Council said there was no medical evidence to
suggest any unsafe practice.

The three deaths were identified by the council’s routine
monitoring of its interim care facility – older patients are
discharged there from hospital to receive rehabilitation while a
care package is put together by social services.

Under the Community Care (Delayed Discharge) Act 2003, social
services departments have three days to find alternative care for
patients who are deemed ready for discharge from hospital before
fines of £100 a day (£120 in London) kick in.

Pam Donnellan, director of social services at Bournemouth Council,
said of the cases: “We are looking into the circumstances of the
deaths with the hospital. Our staff are very careful around what
they believe to be safe discharging practice – that is a higher
priority to us than avoiding a fine.”

Donnellan added that the council was due to carry out a two-month
study with the Audit Commission into the impact fining was having
on social services and on the discharging of patients from
hospital.

A spokesperson for the hospital said: “We have strict protocols to
ensure we discharge people appropriately. We are not aware there
has been a problem.”

Gordon Lishman, director general of Age Concern England, said: “We
are extremely worried about the sharp rise in re-admissions of
older people and a solution must be found to stop this happening.
Pressure to speed up hospital discharges must not be at the expense
of treatment and care.”

David Rowland, research fellow at the school of public policy,
University College London added: “The financial pressures on
councils provide an incentive to get people out of hospital. The
main questions are whether it is possible in this situation to
carry out sufficient assessment and whether there is sufficient
capacity in the market for them to be treated appropriately.”