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Patient early discharge threat

Winter pressures – beds

BMA council chair Chaand Nagpaul has warned the NHS is ‘woefully underfunded’ after a hospital trust told doctors they might have to discharge patients early, despite the risk they could come to harm.

It comes after a memo sent to doctors at the Royal Cornwall Hospitals NHS Trust last week said patients could be discharged ‘earlier than some clinicians would like’, and admitted some patients would be readmitted or ‘possibly come to harm’.

However, the trust’s chief executive and medical director moved to reassure doctors and patients, suggesting patients will be cared for in the community – and the hospital can do more to improve discharge processes.

Dr Nagpaul (pictured below) said: ‘The BMA has repeatedly warned the NHS has been woefully underfunded for more than a decade, and this has resulted in an understaffed service with inadequate numbers of beds and facilities. Just last week we heard that December marked another record low for NHS performance – with one in five patients waiting longer than four hours in [emergency care], and 12,000 waiting more than 12 hours for a bed.

Chaand-Nagpaul-3 GPC chair 2015 16x9

‘In the face of these pressures, this example highlights the frankly unacceptable situation doctors face on the ground, being pressured to discharge patients earlier than is clinically appropriate – putting themselves and patients at risk – owing to a lack of capacity and unprecedented demand.

‘This is a dire indictment of the state our NHS has been allowed to creep into.

He added: ‘Doctors’ primary professional duty is to make the care of their patient their first concern. They must treat the patient in front of them, based on their individual clinical needs, and doctors should never be coerced to go against their expert and considered judgement.’


Black alerts

Dr Nagpaul wrote to the trust to express his concern and affirm support for doctors.

In the letter he said: ‘Following the general election, I wrote to the prime minister raising with him the significant funding gap of £6.2bn between what we believe the NHS requires and what the Government has proposed for the NHS. We stated in this letter that without this funding “we risk patients being let down by the services they and their families depend on”. I am sad to see that this warning is now being borne out across the NHS, including at your trust.’

In recent weeks, the pressures on the trust have been highlighted, with black alerts declared and statistics showing that nearly 2,000 patients waited for more than four hours in emergency departments in December.

Kate Shields, chief executive at Royal Cornwall Hospitals NHS Trust, said the hospital had been ‘very full’ and that some patients could be cared for at home.

She said: ‘We are saying to our doctors and and our occupational therapists and our physios that if there are people that you think can go home and they can be cared for in the community that's what we want you to do. We don't want you to wait and do more and more checks.

‘We want you to trust that our colleagues who work in the health service and in social care outside the hospital are there to look after people we need to send home.

‘We are not asking anybody to send home anybody where there is a present risk around their care or who we really think are not going to be able to cope when they leave the hospital.’

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