Overnight hospital discharges under investigation

12/04/2012

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The UK government is investigating claims that some hospital patients are being discharged overnight. Guidelines are in place to prevent the transport of patients from hospital to hospital overnight, unless there is a clinical need, and likewise discharges home are time sensitive.

As a rule of thumb patients should not be discharged home between the hours of 11pm and 6am. Hospitals have gone a long way to stooping such practices. Sadly they still happen. This is said not simply because of today's news but after more than 12 years working in an NHS hospital.

Problems occur when bed shortages happen. As NHS trusts cut the number of beds available to meet the new budget restrictions it may be a hard thing to prevent. If an emergency admission is in dire need of a bed the alternatives available are numbered.

Elderly and vulnerable patients obviously need careful consideration before discharge but so do many others. It could simply be the area where you live that makes a night discharge not advisable. It does not take much to think of potential problems. It is after all not rocket science.

The Times newspaper has reported on overnight hospital discharges, which in turn has instigated this investigation. As allowed under the Freedom of Information requests in the UK, The Times contacted 170 NHS trusts, but only 100 in England replied. The 100 though had some staggering figures. 239,233 patients were discharged home by these trusts, in 2011, between the hours of 11pm and 6am.

Whilst the government is investigating the claims made by the Times, it is hard to believe that such practices were not known by the government. With a decrease in funding, a decrease in beds and a decrease in staff, inner city hospitals in particular will continue to fail in their bed management.

Tags: NHS trusts, UK health care, overnight hospital discharges
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Hospitals must not use term 'Old Dear'

29/02/2012

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UK political correctness or madness?

In the UK there are many times when we grimace at words, especially when they are directed at us. Different parts of the country have traditionally used "pet" names. This could mean you being called, love, duck, pet, darls, sweetheart and so on. Often it depends who says it, how it is said, the situation and your personal stance as to whether or not it causes offence. For some there is also a little snobbery involved and noses turned up accordingly.

The UK in spite of its many ills is intent on political correctness these days. Yesterday, February 28, 2012, a football supporter was in court for tweeting racist remarks. He was found guilty of two offences under the Malicious Communications Act and only just escaped a jail term.

Racism is one thing though but what about terms such as "old dear?"

Well if you overheard someone calling you an "old dear" you would no doubt be understandably angry, no matter what your age. A new report in the UK is asking that firm guidelines and rules are established. The report calls for ban on the use of patronising language against older people by hospital staff, health care professionals and care workers.

It asks that terms such as "old dear" and "bed blocker" become totally unacceptable. As unacceptable as sexist or racist remarks. The report also states that "compassion" must also be brought back into the care of the elderly. Sky News has reported on the Commission for Dignity in Care, stating "The report calls for an end to 'persistent failings' in elderly care. It says those who fail to show enough compassion towards older people should be barred from entering the health and care professions, even if they have all the required qualifications. It believes the whole system needs fundamental change".

Opinion: Compassion should go without saying. Too many new entrants into the health care professions do not have the necessary caring skills or desires. They enter health as a means to building a career and financial gain. Whilst there is nothing wrong with wanting to progress and prosper, health care needs a certain level of committment. Plus tt needs caring skills.

However barring all "pet" terms seems extreme. Having been a hospital patient and bereaved relative I know that some times such a word or phrase can offer comfort. It can feel more persoanl and genuine than using your full title and name. 

On the other hand having had experience, of the working kind, of a ward where every elderly patient was referred to as Bed 1 or Bed 2 and the like, i know all is not well. When you say to the member of staff, " but yes, what is the man's name in Bed 1" and they have no idea, it is time for change. 

What we need to do however is find a happy compromise.  The report said, "Like many others, we have been deeply saddened by the reports highlighting the undignified care of older people in our hospitals and care homes. In too many cases, people have been let down when they were vulnerable and most needed help.

That of course should not be happening. However there is much more to fix than using the term "old dear"
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