Patients Discharged At Night: 'It's Sickening'

Hospital Discharges: Making Sense Of The Data

Updated: 12:46pm UK, Thursday 22 May 2014

By Thomas Moore, Health and Science Correspondent

Most of us would use a commonsense definition of a "hospital discharge": you've been in a hospital bed and then you're sent home.

But hospitals count discharges in different ways.

Even though the medical director of NHS England flagged up the inconsistency as a concern two years ago, our research shows that it remains a problem.

We asked hospitals for data on their overnight patient discharges.

We got absolute numbers.

But we know that hospital admissions are rising, so it would be unfair to compare total discharges now with those two years ago.

So we asked for the proportion of discharges that were made overnight - a fairer way of tracking what is going on.

But even that can be tricky to interpret.

One hospital merrily reported that half its discharges were at night.

We queried the figures and it turned out that nurses were catching up on paperwork overnight and recording the time of day, not the time of discharge. Extraordinary.

Some hospitals say their discharge figures include patients in beds in assessment units, others strip those out.

And other hospitals say they mistakenly included newborn babies being sent home.

It begs the question: how do hospitals measure inappropriate discharges overnight if they have such muddled data?

So with such inconsistency it is impossible to make accurate head-to-head comparisons between hospitals.

But you can track individual hospitals over the years.

And our research does show that in 31 of the 72 hospitals that actually collect and supplied the data the proportion of overnight discharges is rising.

Yes, two years after NHS England ordered hospitals to stop the practice, in some it is still rising.

And judging from the phenomenal feedback we're getting, these aren't all patients who willingly discharged themselves.

The NHS has a problem, but some hospitals are in denial.

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