Scandal of sick patients rushed out of hospital

THE misery endured by patients because of the NHS’s “revolving door” policy of early discharge and emergency readmission is exposed today in a report by the official watchdog.

One million patients are readmitted to hospital as emergency cases within 30 days of discharge because they were “rushed out of the door” too quickly, at a cost of £2.4 billion per year.

Healthwatch England said it had gathered “thousands of shocking stories” about patients sent home without proper care and support. They included a mentally ill man discharged after a suicide attempt with no followup care who killed himself a week later.

The watchdog concluded that “an undercurrent of ageism” persists in the health service, and that some of the most vulnerable people in society – pensioners, the homeless and the mentally ill – are being badly let down.

Among the personal stories detailed in the report are:

An 81-year-old sent home in a taxi at 10.30pm following a severe stroke who was back in hospital days later.

A cancer patient sent back to his unheated home in winter who was found freezing and struggling to breathe by a nurse who had to break into his flat.

A man discharged from a mental health unit who rang an out-of-hours number only to be told: “Can’t you just read a book or do a crossword for the next five hours?”

The “common basic failings” unearthed by the comprehensive survey of patients included hospitals not rou- tinely asking patients if they had anywhere to go, details of new medications not being passed on to GPs and carers, and families not being notified when loved ones left hospital.

The Safely Home report points out that similar systemic failings have been taking place for decades because “artificial boundaries” between managers, clinicians and care workers enable them to dodge the blame.

Healthwatch England, through its network of 101 local watchdog groups, gathered evidence from 3,230 patients. It found that unsafe, delayed or untimely discharge from hospital was commonplace due to a lack of co-ordination between health, social care and community services. Many patients felt discriminated against or stigmatised during their care, leading them to feeling “rushed out of the door”.

Patients were often not involved in decisions about their ongoing care. One woman described how her husband was discharged after a suicide attempt, despite his repeated pleas to stay because he did not feel able to cope. No follow-up care was offered upon discharge and he killed himself the following week.

Patients whose discharge was delayed included a mental health patient who was ready to go home but stayed in hospital for months longer because of a row over how much the funding bodies were willing to pay for his outpatient support.

In the past decade, emergency readmission for those aged 75 and over has increased by 88 per cent. The report states: “From what we heard, we

understand there may be an undercurrent of ageism within some parts of the health and social care sector and, whilst other forms of discrimination are no longer deemed to be acceptable, this continues.”

Anna Bradley, chairman of Healthwatch England, said: “Throughout the inquiry we have heard thousands of shocking stories about what happens when people leave hospital without the right planning and support.

“This is not a new problem, but what makes these findings worse is that in many cases some pretty basic things could have made all the difference.

“There is a huge human and financial cost of getting discharge wrong. We hope that the increased focus on integration of health and social care, and pressure on finances, will create a new impetus to fix it.”

Phil McCarvill, the deputy policy director of the NHS Confederation, which represents hospitals, community and mental health providers, said: “The scale and complexity of the NHS can sometimes make the experience of care feel less tailored to individuals’ needs.

“Delivering compassionate, dignified care must be the top priority of everyone who works in the NHS.”

Janet Morrison, the chief executive of the Independent Age charity, added: “The revolving door approach to hospital discharge is letting patients down. The report shows this is not just bad for patients but also for the system as a whole, with huge financial implications. The process can be confusing for older people and their families as they’re often asked to make complex and difficult decisions when they’re already under considerable pressure.”