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.”

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