Hospitals may be treating patients as part of “production line” with early discharges requiring readmissions: Report

By Dr. Ananya Mandal, MDJan 1 2012

After figures revealed that hundreds of thousands of people every year are being sent home before they are well enough, hospitals have been accused by ministers of treating patients “like parts on a production line.”

More than 660,000 people were brought back to hospital last year within 28 days of leaving, statistics show, sparking allegations that patients are being “hurried through the system” so the NHS can meet waiting-list targets. The official figures show that some NHS trusts have seen their emergency readmission rate rise more than three-fold over the past decade – while some hospitals have seen only a modest increase.

According to Andrew Lansley, the Health Secretary the “hugely distressing” trend must stop. “Patients have a right to expect that when they go in for treatment that they are looked after properly and that the treatment they are given helps them to recover,” he said. “Having to be readmitted and treated all over again is hugely distressing. These figures show how Labor’s obsession with waiting time targets meant that patients were treated like parts on a production line to be hurried through the system rather than like people who need to be properly cared for.”

The Department of Health has released detailed information on the number of emergency readmissions in every area across Britain. The figures show –

• 620,054 patients had to be readmitted in 2009-10 – compared to just 348,996 a decade before, a 78 percent increase.
• Over the past five years, there has been a 31 percent rise and a five percent increase on the previous 12 months.

The data also highlights the widespread regional variations.

• The rate of readmission in the Kensington & Chelsea PCT area has risen by 287 percent over the past decade to 1,582 people.
• North Lincolnshire PCT has only experienced a 3.37 percent rise over the same period. Hospitals within the Hampshire PCT area readmitted 13,239 people last year.
• The nearby area covered by the Isle of Wight PCT only had to readmit 1,098 people.

These figures do not include patients suffering from cancer or mental health problems or maternity patients. About 10 million people are admitted to hospital wards each year. Critics claim that government targets, such as the demand that patients be admitted to hospital for treatment within 18 weeks of seeing their GP, mean hospital managers are pressured into releasing patients early to make beds available.

Mike Farrar, the head of the NHS Federation, said, “Hospitals play a vital role, but we do rely on them for some services that could be provided elsewhere. We should be concentrating on reducing hospital stays where this is right for patients, shifting resources into community services, raising standards of general practice, and promoting early intervention and self care.”

Yesterday, Jacqui Davis, head of the NHS Consultants’ Association, said, “Why would you want to have people isolated in their homes? This is not going to save money and it is unfortunately the wrong message. GP’s are swamped, social services are having their budgets cut. While it may be more appropriate for more people to be treated within the community we simply can’t do it without making much better arrangements than we’ve got at the moment.”

Mr Lansley said, “Instead of focusing on the results which actually matter for patients, they focused on narrow processes to the detriment of patient care. That is why we have taken action to address these increases in emergency readmissions. One of the new goals we are setting the NHS is reducing emergency readmissions. In order to help achieve this we have created a re-ablement fund of £300 million and we have taken action to stop hospitals being paid when they readmit a patient after discharging them too early. These steps will turn Labour’s poor performance around.”

Under the Government scheme, hospitals will effectively be responsible for people’s care in the weeks after they return home and will be financially penalized for discharging patients too soon.

Ministers have also increased funding for so-called “tele-health” where people can “manage” their long-term conditions independently at home but are remotely monitored by doctors. The official figures have been released as NHS managers claimed that one in four people being treated in hospital should be at home – which could lead to even more re-admissions if the programme is not properly monitored.