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Patient discharges at night put patients at risk

Research by The Times has revealed that hundreds of thousands of NHS patients are being discharged between the hours of 11pm and 6am to relieve pressures on beds.

Often at risk are the elderly and the vulnerable, where they are abruptly sent home without proper planning and often to empty homes. It has been suggested that with the cuts looming, this situation may escalate.

Specialist medical negligence solicitor Graeme Swain said, “We think this puts patients at risk of falls and of general neglect.”

Hospital managers have responded to the findings saying that discharging patients in this manner could be an ‘under the radar’ method of freeing up beds, and in many cases would not be in the interests of the patients. Graeme goes on to say, “We are also concerned that proper checks may not be carried out with the result that the chances of a medical mistake are increased. Patients could be discharged with a lack of proper advice about future health care and in particular when and why urgent attention may be required in future. Patients may be vulnerable to a relapse and be lacking a supportive care arrangement.”

The Medical Director of the NHS, Sir Bruce Keogh, warned that this practice should be avoided and has promised an investigation into why late night discharges happen and how to reduce the number of occurrences.

The Times research has revealed big disparities between hospital trusts. Derby hospital Trust sent home 8.7% of their patients home between 11pm and 6am in 2011-2012. The Heart of England NHS Trust in Birmingham, Countess of Chester and University Hospitals of Leicester also have rates above 7%. But other fare much better, with rates below 1%.

While it is appreciated that pressures are placed on the NHS resources, it is unacceptable for patients to be asked to leave the hospital in the middle of the night, particularly the elderly and vulnerable who often only have an empty home to go to. Patients have complained to the Patients Association, often claiming that they were not given enough time to contact relatives about what was happening.

Patients should only be discharged when it is clinically safe, appropriate and convenient for them and their families and late night discharges for some patients does not meet this criteria. Patients can be put at risk. Sometimes late night discharges are acceptable where the patient asks for it, such as in maternity where mothers are keen to go home. However, it is the elderly and vulnerable late night discharges that concern Swain & Co.

If patients who are elderly and/or vulnerable are being sent home without the proper time to plan, or their families having prior notice, it causes unnecessary distress and also increases the risk of having to return to hospital as an emergency readmission.  Swain & Co.’s Tina Smith said, “If an elderly person suffers an unnecessary fall the consequences for them can be devastating. Typical injuries sustained by patients include broken hips and fractures of the legs, wrists and arms.”

In extreme cases that dramatise these findings, an 82 year old woman who had broken her arm was sent home, after it was set, at 3am. She lived alone in a flat and had no relatives, but was expected to manage on her own with no care. In another example, a 92 year old man was taken to hospital by ambulance with breathing problem and was then sent home by taxi at 1am. He lived on the 10th floor in a block of flats, and it became clear he needed his wheelchair to move. The taxi driver refused to get it, so a support officer from the building had to be called out.

Swain & Co. has specialist clinical negligence teams and we provide a national service. Contact Graeme Swain or Tina Smith on 0800 0351 999. We act on a no win no fee basis and under legal aid.

At Swain & Co we also have a specialist team in Community Care which covers care and treatment that elderly and vulnerable adults may be receiving. So if you, or a loved one, are concerned over treatment then please contact our specialist community care team on 02392 483322.

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