NHS medical director orders hospitals to cut night discharges

The medical director of the NHS in England said hospitals should take 'ownership' of night-time discharges as a 'matter of urgency'.

Sir Bruce Keogh: 'Patients should only be discharged when it's clinically appropriate.'
Sir Bruce Keogh: 'Patients should only be discharged when it's clinically appropriate.'

NHS medical director Professor Sir Bruce Keogh’s letter to SHAs at the weekend comes after The Times revealed there had been 239,233 discharges between 11pm and 6pm across 100 hospital trusts last year.

The letter to SHA medical directors reads: ‘While some patients may of course choose to be discharged during these hours, the examples highlighted of elderly patients being left to make their way home by themselves in the middle of the night are obviously unacceptable, and need to be addressed urgently.

‘Discharge or care transfer is of course an essential part of care management in any setting. It ensures that health and social care systems are proactive in supporting patients and their families and carers to either return home or transfer to another setting. It also ensures that systems are using resources effectively.’

Out of the 170 English hospital trusts asked for data under the Freedom of Information Act, only 100 responded.

Sir Bruce acknowledged the difficulty in making ‘like for like’ comparisons because some of the data provided by hospital trusts included self discharges, patients in assessment units and deaths while other trusts focused solely on discharges. Despite this, he warned: ‘The challenge to the NHS is absolutely clear - that patients should only be discharged when it is clinically appropriate, safe and convenient for them and their families.’

He asked the recipients approach all hospital trusts and ask them to review their practices, adding: ‘It is important that trust boards take ownership of this issue, so I would expect medical directors, working with their nursing director colleagues, to ensure that the findings of their reviews are reported to their boards at the earliest opportunity.

‘I would like your assurance that appropriate arrangements are in place in all NHS trusts to ensure timely discharge and care transfer for all patients, and I expect to discuss the outcome of the actions I have requested when we next meet on 8 May.’

Before commenting please read our rules for commenting on articles.

If you see a comment you find offensive, you can flag it as inappropriate. In the top right-hand corner of an individual comment, you will see 'flag as inappropriate'. Clicking this prompts us to review the comment. For further information see our rules for commenting on articles.

comments powered by Disqus


A-Z listing of therapeutic areas. Find the latest clinical news and education


Browse a list of all of the pages and topics on GPonline

Pain Resource Centre

Information on chronic and neuropathic pain

Otitis Externa Toolkit

Resources to help treat this outer ear infection

GPs practising in the UK can request to receive free copies of GP by completing our online registration form. For paid subscriptions to GP visit our subscriptions site.