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PCTs unveil new plans for early hospital release

By Nigel Praities

Financially–stricken trusts are planning to pile further pressure on GPs by ramping up efforts to clear patients out of hospital more quickly, in an attempt to cut spending on hospital care.

PCTs are taking drastic action to reduce outlay on secondary care contracts as they face up to the possibility of serious overspending, with some in danger of breaching a statutory duty to break even.

Pulse has learned that as well as attempting to address the sharp increase in GP referrals, trusts are bringing in measures to reduce the time patients spend in hospital, despite fears it could fuel rises in emergency re-admissions.

Buckinghamshire PCT, which is facing a £7.5m deficit, has revealed plans to save £1m by moving patients out of hospital earlier.

It plans to slash costs by the equivalent of 182 bed-days per week, which will include the closure of one hospital ward, by providing ‘community-based rehabilitation of medically fit patients after non-elective or elective episodes'.

Hampshire PCT, which is facing an overspend of nearly £25m, said action needed to be stepped up as measures taken to reduce ‘excess bed days' were ‘not delivering savings as planned'.

Devon PCT also has a policy to shift patients into the community, alongside a referral management programme, in order to eradicate its projected deficit.

But the increased drive to reduce bed days comes despite Pulse revealing in October that evidence was emerging linking minimising of hospital stays to an increase in emergency readmissions,

Figures showed a 12% leap in emergency readmissions over the first three quarters of 2007 – the first period readmissions within 14 days were measured - leading Dr Jonathan Fielden, chair of the BMA consultants' committee, to warn trusts were ‘pushing people out early'.

Dr Tanvir Jamil, a GP in Burnham, Buckinghamshire, said he was concerned there was not enough staff or beds in his area to look after patients effectively in the community.

‘There is a slight danger we are asked to review patients earlier and they go back into hospital earlier, taking up more patient beds. There is the infrastructure is there to look after patients but there is not the staff or the resources,' he said.

Trusts want to speed up patients' exit from hospital Trusts want to speed up patients' exit from hospital

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