Delayed discharge policy could create readmissions, NHS watchdog warns

    Emergency hospital readmissions of older people have gone up as
    delayed discharge rates have fallen, raising concerns some patients
    are being discharged too quickly, writes Craig
    Kenny
    .

    The Healthcare Commission’s annual State of Healthcare Report
    finds that while the proportion of delayed discharges among
    over-75s almost halved between September 2001 and March 2003 from
    12 to 6.5 per cent, the proportion needing emergency readmission
    within 28 days rose from 7.1 to 8.2 per cent over the same
    period.

    “Older people must not be rushed back into independent living
    before they are ready,” the report warns. “If they are,
    there may be a greater risk they will quickly need to be readmitted
    to hospital. There is some evidence that this may be happening with
    increasing frequency.”

    The figures follow earlier concerns that pressure on health and
    social services departments to free up beds quicker could encourage
    doctors to discharge patients from hospital before they are fully
    ready.

    Under the government’s delayed discharge reimbursement
    system, which came into force in January, social services
    departments can now be fined £100 (£120 in London and the
    south east) per day for any patient not given a care package within
    three days of discharge notification.

    The report reveals that the percentage of patients aged over 75
    whose discharge was delayed in each of the 28 strategic health
    authorities varied from 3.2 to 15.4 per cent in England in the year
    to March 2003. The highest rates were in southern English counties
    such as Hampshire, Surrey and Sussex, where high property prices
    squeeze out residential care, the report states.

    Hospital staff should discuss home care arrangements with older
    patients before discharging them, adds the report, highlighting
    that this did not happen in almost one quarter of cases.

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