'Political maladministration' to blame for high level of unsafe hospital discharges

NHS staff must always ensure patients take priority over organisational pressures, a report into unsafe hospital discharges has urged.

The report by MPs published today [28 September] found an unacceptably high level of unsafe hospital discharges, which it blamed on ‘political maladministration’.

The document highlights the human anguish behind delayed transfers of care and premature discharges from hospital.

The report by the Public Administration and Constitutional Affairs Committee follows its inquiry to which the RCN gave evidence, highlighting the systemic issues that play a role in unsafe discharges.

Improvements

The RCN said delayed discharges could be improved by better recruitment and retention of nurses, appropriately funded social care, and investment in the district, community and social care nursing workforce.

The committee’s inquiry and findings follows a previous report by the Parliamentary and Health Service Ombudsman (PHSO) into the issue.

The latest inquiry found that the discharge problems identified by the PHSO report were not isolated but more widespread – leading MPs to call for data gathering on these failures.

Under pressure

Committee chair Bernard Jenkin MP said: 'Hospital staff seem to feel pressured to discharge patients before it is safe to do so.

'Hospital leadership must reassure their staff that organisational pressures never take priority over person-centred care.

'And staff need to feel a level of trust and openness that enables them to raise concerns about unsafe discharge.'

Discharge teams

RCN chief executive Janet Davies gave evidence to the inquiry and condemned the use of ‘discharge teams’ who are responsible for identifying patients who may be discharged, in order to increase bed availability.

'When the focus is on beds rather than the person, that is when we sometimes find those difficulties [with poor discharge],' she said.

The report, Follow-up to PHSO Report on Unsafe Discharge From Hospital, also points out that discharge processes vary across England.

It highlights that almost no patients at Northumbria Healthcare NHS Foundation Trust end up waiting in hospital to return home or transfer to another setting.

Community and social care teams

Northumbria Healthcare NHS Foundation Trust chief executive David Evans said: ‘While we always try to avoid people coming into hospital unless it’s absolutely necessary, if patients do require a hospital stay, it’s about planning their discharge as early as possible.

‘Key to this is involving our community and social care teams while the patient is in hospital to ensure when they do go home it’s as seamless as possible and all the care and support they need to manage is in place.

‘It’s so important that patients are able to go home when they’re medically fit.

‘It’s also about making sure that services are available seven days a week so there is no disruption to services over a weekend for example.’