Emergency readmissions jump 40% in seven years
Emergency readmissions for potentially preventable conditions including pneumonia and pressure sores are up by 40% in seven years, raising questions about the quality of care given to older people, according to a study by two health think tanks.
Most readmissions examined by the Nuffield Trust and the Health Foundation were for conditions that had not been diagnosed during patients' original hospital stay.
The RCN blamed the trend on the volume of nursing vacancies in the NHS and called on the government to take urgent action, including enshrining safe staffing levels in law.
Readmission data covering the period 2010-11 to 2016-17 obtained from hospitals in England were examined by QualityWatch, a research programme run jointly by the think tanks.
Findings include:
- A 19% rise in patients needing an emergency readmission to hospital within 30 days of discharge – up from 1,157,570 cases to 1,379,790.
- A 41.3% rise in emergency readmissions for conditions researchers classify as ‘potentially preventable’ – up from 130,760 cases to 184,763.
- Emergency readmissions for pressure sores almost trebled from 7,787 to 22,448. The increase in the number of patients being readmitted with a pressure sore superseded the overall increase in the number of pressure sore diagnoses in hospital.
Warning sign
The researchers said the findings raise questions about the quality of care older people receive during hospital stays, how they are discharged from hospital and the quality of community and social care services.
Nuffield Trust director of research John Appleby said: ‘Unnecessary trips and overnight stays in hospital put a strain on patients and their families.’
Professor Appleby’s colleague, research analyst Jessica Morris, said: ‘Emergency readmissions to hospital, for conditions that were not diagnosed during their first visit, are potentially a warning sign that a patient’s quality of care may have been compromised.
‘The findings are a good opportunity for local healthcare providers to sit up and focus their attention and quality improvement initiatives on the three conditions where we’ve seen the most significant rise in readmissions.’
Too few nurses to give the best care
RCN director of nursing, policy and practice Dame Donna Kinnair said the findings reflected the impact of an estimated 40,000 nurse vacancies on patient care. ‘Nurses want to do the best they can for their patients, but with hospitals struggling to recruit and shifts left unfilled there are too few nurses to deliver the best care,’ she said.
‘To improve patient care, the government urgently needs to recruit and retain more nurses, and enshrine safe and effective staffing levels in law.’
The RCN estimates there are 40,000 nurse vacancies in England based on data from 2017. NHS Improvement figures published this week suggest that as of April there were 35,794 whole-time equivalent nurse vacancies.
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