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Emergency readmissions to hospital up by more than a quarter over last decade

Emergency readmissions to hospital have increased by 27% over the last 10 years, according to new Government figures.

Data published by the Health and Social Care Information Centre for the 2011/12 financial year show that readmissions within 28 days of discharge have increased by up to a third for some conditions.

The figures come as GPs face increasing pressure to clamp down on unplanned admissions via the new DES announced as part of the 2014 GP contract. Under the DES, GPs will have to work with hospitals to review and improve discharge processes as well as undertake internal reviews of unplanned admissions and readmissions.

The continuing rise in readmissions could also threaten CCGs ability to achieve their quality premiums. A recent Pulse investigation found that reducing emergency readmissions was one of the most popular priority indicators chosen by CCGs for the local element of their quality premium, with the three local indicators chosen collectively worth around £420,000 for the average CCG with a population of 226,000.

The HSCIC data shows an increase of around 27% in the total number of emergency readmissions, including:

- a 36% increase in the readmissions rate for stroke

- a 32% increase in the readmissions rate for fractured proximal femur

- a 27% increase in the readmissions rate for hysterectomy

- a decrease of around 14% in the readmissions rate for primary hip replacement surgery.

Dr Steve Kell, chair of NHS Bassetlaw CCG and co-chair of NHS Clinical Commissioners, said: ‘Hospital readmissions are a concern for patients, CCGs and providers. They reflect issues within the wider system including social care and will be a focus for all areas.’

‘They highlight the need for effective out-of-hospital commissioning, including primary care, and CCGs should have an active role in commissioning this in the future if we are to improve the whole system for our patients.’

GPC chair Dr Chaand Nagpaul said the figures showed that tackling unplanned admissions was the repsonsibility of hospitals as well as GPs.

‘The Keogh report makes it clear that the pressure on hospitals is about the whole system,’ he said. ‘So let´s be absolutely clear, the DES is not the solution to wider pressures. While it will play a part in reduced unplanned admissions it’s totally inappropriate to expect it to make a difference to these statistics.”