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The waiting game

GPs set to care for patients ‘urgently’ discharged from hospital

Patients fit for discharge are to be moved out of hospital ‘urgently’ to free up beds in England, suggesting GPs will be left to care for them in the community.

NHS England said in a letter to GPs, hospital and community bosses yesterday that the move could release 15,000 acute beds for patients with coronavirus.

Patients already awaiting discharge or those who have been in hospital for over 21 days will be targeted.

Community health providers ‘must take immediate full responsibility’ for discharging eligible patients, said the letter, signed by NHS chief executive Simon Stevens.

Emergency legislation introduced this week will ensure patients requiring social care can be discharged without being held up by eligibility assessments.

Additional funding to pay for the care of patients being discharged is due to be released in financial guidance this week.

The letter said: 'Community health providers must take immediate full responsibility for urgent discharge of all eligible patients identified by acute providers on a discharge list.

'Trusts and CCGs will need to work with local authority partners to ensure that additional capacity is appropriately commissioned. This could potentially free up to 15,000 acute beds currently occupied by patients awaiting discharge or with lengths of stay over 21 days.'

It added: ‘Financial constraints must not and will not stand in the way of taking immediate and necessary action - whether in terms of staffing, facilities adaptation, equipment, patient discharge packages, staff training, elective care, or any other relevant category.’

Meanwhile, all NHS non-urgent elective operations are to be postponed for at least three months as part of plans to release a further 15,000 hospital beds across England for coronavirus patients.

NHS England’s letter said emergency admissions, cancer treatment and other clinically urgent care should continue unaffected.

But non-urgent operations will need to be delayed from 15 April ‘at the latest’.

The letter said NHS organisations will have ‘full local discretion’ over how to wind down elective procedures over the next month.

The approach is aimed at releasing staff for refresher training, creating beds for patients affected by Covid-19 and ensuring more capacity for theatres and recovery facilities.

Up until the postponement arrangements are in place, organisations should ‘continue to use all available capacity’ for elective operations ‘including the independent sector, before Covid constraints curtail such work,’ said the letter.

NHS England said it believed the measures could free up 12,000-15,000 hospital beds across England.

It is part of wider efforts announced today designed to release at least 30,000 general and acute hospital beds in the NHS in England, which is around a third of the total number.

The letter said: 'Trusts are asked now to assume that you will need to postpone all non-urgent elective operations from 15th April at the latest, for a period of at least three months.

'However you also have full local discretion to wind down elective activity over the next 30 days as you see best, so as to free up staff for refresher training, beds for Covid patients, and theatres/recovery facilities for adaptation work.

'Emergency admissions, cancer treatment and other clinically urgent care should continue unaffected.’

Readers' comments (41)

  • F3cking how exactly? Joined up thinking would be to much to ask for as usual....... not enough GPs, not enough PPE, and now care for patients at home.... which planet? I predict that this crisis will lead to the resignation of many health care staff one way or the other.... already burnt out NHS staff cannot cope with whats about to come.... it will force many to resign irrespective of age...... I think the psychological impact of whats to come with all the stresses of children at home, which will happen in time, elderly relatives in isolation, an unemployed spouse, no toilet paper :-) is going to lead to breaking point for many citizens....

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  • Look on the bright side... at least everyones stopped talking about Brexit for a change!!!!! Puts it in perspective doesnt it?

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  • Health and safety. Where are the helmets and FFP3s the hospital has? At least have one per practice to share. The district nurses are refusing to go as they have no protection. Not going to happen.
    Firemen fight fires with fire retardant clothing. We get nothing.

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  • I'm hoping this pandemic initiates the collapse of the NHS.

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  • The children and I are at home now for two weeks. The will be no GPs left soon. GET HEALTHCARE WORKERS TESTED!!!

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  • We have had a broken system for many years. Just takes a sudden shock to totally destroy it. We have had acute trusts which are not fit for purpose for the population they serve. A new model is desperately needed. Acute trusts for intensive treatment but many many more community beds for the fluids and antibiotics or simple care that the elderly may need from time to time, with dignified nursing care and social care arrangements. Time to wake up and realise we have done it all wrong.

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  • I may be the only one - but this reads to me as if it's largely about discharging patients who are currently stuck in hospital beds awaiting social care packages.

    If so, this would be a good thing.

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  • this week the local community hosp discharged a pt without any care package. they fell in night and was injured. fortunately they were ok. they are unable to stand unaided. I have arranged emergency care but if they had been injured they would have been back in hospital. we were not informed of the discharge by the local services and no discharge letter was sent to us. This is not an unusual occurrence. You discharge them without support we have to send them back in. covid or no covid. there is no where else for them to go to keep them safe. its all very well discharging these patients into the community but they need the support straight away, otherwise, like my patient this week, you put them at risk. I have had a patient discharged at 0200 in the morning who has dementia and the carers were not aware. This is our reality. Nursing homes are full, there is a shortage of social workers and carers. Its a bad move.

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  • @ Dylan | Salaried GP18 Mar 2020 11:56am

    not when you have to deal with it and anything that goes wrong is your responsibility

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  • Who's going to see them? We've now got 1/5 of our workforce off due to family members having temp / cough etc so unless they're going to start testing NHS workers families to see who can return to work this there's no chance.

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