Posts Tagged ‘Re-admissions’

Operating framework mired in chaos theory

By Stephen Campion, HCSA chief executive - 4th February 2011 6:17 pm

I do not intend to make the same mistake as Top Gear by insulting foreigners. I am sure Mexicans are lovely people. And so too are Egyptians many of whom are not only excellent doctors here in the UK but must be very concerned about what is happening back home.

But having returned from a meeting of all trade unions at a large foundation trust on the south coast I could not help but think of the words of President Mubarak: “I do not want to resign now - it would cause chaos!” As if there was not enough chaos already.

It seemed to me that those same sentiments might be expressed by the management of NHS trusts and PCTs as they in turn are wrestling with the very chaos that besets many parts of the NHS. Being unusually charitable to them though it soon emerged that the NHS operating framework is part of the chaos.

There we were listening to the chief executive explaining why the trust had to save £5m on its wage bill this year. His target is considerably less than some other trusts - but nevertheless it is a significant amount. So what would we, the unions agree to? Various options were put on the table. A universal 2% pay cut. Withholding salary increments. Encouraging secondment and sabbaticals. Donating loose change in the salary slip to the financial cause. Buying added annual leave. A variation of the supermarket theme - work four days give one free! Increased car parking charges (now there’s a novel idea). Forcing all those already over 65 to leave now before the age discrimination laws kick in. And so it went on.

Not unreasonably the question was asked why the trust was in this mess. This is where the NHS chaos assumed Egyptian proportions. Maybe I should have twigged to this earlier but the trust has to budget £3.2m to cover the costs of anticipated patient re-admissions even when that re-admission within 30 days has absolutely nothing to do with the original treatment.

Having learnt this it became a bit more difficult to be sympathetic to the need to consider which bitter pill was the best to swallow! Chaos? What chaos?

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A new area of practice for the Loophole Department

By Bob Bury - 14th June 2010 9:03 am

Just when you thought it was safe to start reading the papers again, there’s a another outbreak of political twattery - this time from the new lot. Andrew Lansley wants to fine hospitals if they re-admit patients within 30 days of discharge. None of you need me to point out what a facile load of ordure this represents - others have done that already, and when even The Guardian’s health correspondent can foresee problems, it should be clear to anyone that the Secretary of State for Health has inherited his predecessors’ difficulty concerning orifice selection when making policy statements.

Still, it will open up a whole new area of practice for the Trust Loophole Department (you know, the people who dreamed up the ‘clinical decision unit’ concept to avoid breaching the A&E 4 hour wait target, and the re-badging of any nurse with more than three GCSEs as a ‘consultant’ to avoid the inconvenient tendency of real doctors to want to keep patients hanging around long enough to actually examine them). They will now be able to support the focus-group driven initiative to provide care closer to the patient’s home by establishing a complex bureaucracy to ensure that no patient gets re-admitted during the penalty period. This will give GPs a valuable opportunity to hone their skills and acquire new ones. COPD patients, discharged after their latest exacerbation, will have their day 14 left anterior descending occlusion managed for a couple of weeks by Dr Finlay and the home angioplasty team (one nurse practitioner who has ‘done the course’ assisted by a couple of slack-jawed teenagers undertaking their work-experience as Auxiliary Interventional Technicians), until they (well, the lucky few) can be admitted to the CCU for salvage on day 31. Brave new world indeed.

To think that we had high hopes of Andrew. Perhaps they really are all the same? That would be depressing.

Oh well, it won’t matter for most of us, if the Daily Mash is to be believed - we’ll all be on the beach.

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Hospitals to be penalised for patient re-admissions

HSJ - 8th June 2010 8:49 am

Hospitals will face financial penalties if patients are readmitted as an emergency within 30 days of being discharged, under government plans being announced today.

Hospitals will get paid for initial treatment but will not be paid again if a patient is brought back in with a related problem, health secretary Andrew Lansley will say.

It has been argued that some patients are discharged too soon and without proper care plans in place.

The Conservatives have also said cuts to the number of hospital beds under Labour put pressure on NHS staff to discharge people without support.

Between 1998-99 and 2007-08, the number of emergency readmissions in England rose 52% from 359,719 to 546,354.

Speaking about his vision for the NHS, Lansley will call for patients to be given more control over their health.

Read more at HSJ. 

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