David Cameron, our Prime Minister, said in his New Year message:
“I am determined to do the bold things it will take to sort out public services, too. Too often our schools aren't up to scratch, our hospitals aren't always clean enough and our police don't catch criminals. Brilliant and committed people work in public services - but somehow the system stops them doing their job. So we'll change it.”
Nice words Dave, but do you know what to do? Do you know what you’ve done?
NHS 'production line'
Perhaps, Dave, you should consider the health service. Recent news reports tell us that lots of people discharged from hospital are readmitted, within a month, as emergencies; and the numbers are increasing. Oblivious to their role in creating this shocking state of affairs, your ministers blame the hospitals for treating patients “like parts on a production line”.
But who built the system Dave? Who mandated ‘payment by results’, commissioning, protocols and targets? Do you know, Dave, how these things create the churn of patients?
Read the news report here:
Scandal of NHS 'production line' as readmissions soar
The number of NHS patients who have to undergo emergency readmission to hospital within a month of being discharged has increased by more than three quarters in the last decade, the Daily Telegraph can disclose.
9:54PM GMT 29 Dec 2011
Hospitals have been accused by ministers of treating patients “like parts on a production line” after official figures suggested that hundreds of thousands of people every year are being sent home before they are well enough.
More than 660,000 people were brought back to hospital last year within 28 days of leaving, statistics show, sparking allegations that patients are being “hurried through the system” so the NHS can meet waiting-list targets.
The official figures show that some NHS trusts have seen their emergency readmission rate rise more than threefold over the past decade – while some hospitals have seen only a modest increase.
Last night, Andrew Lansley, the Health Secretary, said that the “hugely distressing” trend must stop.
“Patients have a right to expect that when they go in for treatment that they are looked after properly and that the treatment they are given helps them to recover,” he said.
“Having to be readmitted and treated all over again is hugely distressing. These figures show how Labour’s obsession with waiting time targets meant that patients were treated like parts on a production line to be hurried through the system rather than like people who need to be properly cared for.”
The Department of Health has released detailed information on the number of emergency readmissions in every area across Britain.
The figures show that 620,054 patients had to be readmitted in 2009-10 – compared to just 348,996 a decade before, a 78 per cent increase. Over the past five years, there has been a 31 per cent rise and a five per cent increase on the previous 12 months.
The data also highlights the widespread regional variations. The rate of readmission in the Kensington & Chelsea PCT area has risen by 287 per cent over the past decade to 1,582 people.
However, North Lincolnshire PCT has only experienced a 3.37 per cent rise over the same period.
Hospitals within the Hampshire PCT area readmitted 13,239 people last year. The nearby area covered by the Isle of Wight PCT only had to readmit 1,098 people.
The figures, do not include patients suffering from cancer or mental health problems or maternity patients.
Most of the areas with the highest increases in readmission numbers are in London and the south east, where pressure is greatest on the NHS. The Department of Health has analysed the social make-up of each area and concludes that the so-called “thriving London periphery” – the relatively wealthy commuter hinterland around the capital has suffered the biggest recent deterioration.
Some of the rise in readmissions may be due to the increase in population in these areas or changes in the way that the data is collected.
About 10 million people are admitted to hospital wards each year. Critics claim that government targets, such as the demand that patients be admitted to hospital for treatment within 18 weeks of seeing their GP, mean hospital managers are pressured into releasing patients early to make beds available.
Earlier this month, The Daily Telegraph disclosed that the Government is moving from a system of targets for hospitals based on waiting and treatment times – to a system of so-called “outcomes” which measures the success of treatment.
In a criticism of previous targets which he blames for the increase in emergency readmissions, Mr Lansley said: “Instead of focusing on the results which actually matter for patients, they focused on narrow processes to the detriment of patient care. That is why we have taken action to address these increases in emergency readmissions.
“One of the new goals we are setting the NHS is reducing emergency readmissions. In order to help achieve this we have created a re-ablement fund of £300 million and we have taken action to stop hospitals being paid when they readmit a patient after discharging them too early. These steps will turn Labour’s poor performance around.”
Under the Government scheme, hospitals will effectively be responsible for people’s care in the weeks after they return home and will be financially penalised for discharging patients too soon.
Ministers have also increased funding for so-called “tele-health” where people can “manage” their long-term conditions independently at home but are remotely monitored by doctors.
The official figures have been released as NHS managers claimed that one in four people being treated in hospital should be at home – which could lead to even more readmissions if the programme is not properly monitored.
Mike Farrar, the head of the NHS Federation, said: “Hospitals play a vital role, but we do rely on them for some services that could be provided elsewhere. We should be concentrating on reducing hospital stays where this is right for patients, shifting resources into community services, raising standards of general practice, and promoting early intervention and self care.”
However, concerns are growing that GPs will be unable to cope with the demands of more people being treated at home. Earlier this week, it emerged that some GP practices now had up to 9,000 people registered.
Yesterday, Jacqui Davis, head of the NHS Consultants’ Association, said: “Why would you want to have people isolated in their homes? This is not going to save money and it is unfortunately the wrong message.
“GP’s are swamped, social services are having their budgets cut. While it may be more appropriate for more people to be treated within the community we simply can’t do it without making much better arrangements than we’ve got at the moment.”