Hospitals face re-admission charges

8/06/2010

 

The health secretary, Andrew Lansley, will today announce plans to make hospitals responsible for patients for up to a month after they are discharged.

In a keynote speech, he will make it clear it is not acceptable for patients to be sent home until their treatment is complete and they are fully fit. Emergency readmissions are not only traumatic for patients but are very expensive for the NHS.

The legislation will also scrap dozens of hospital targets introduced by Labour, which Mr Lansley believes have led to “perverse” decisions being taken by the NHS.

As part of a series of major reforms, hospitals will be penalised financially if patients have to be readmitted within 30 days because their conditions were not treated properly.

About 500,000 patients – around five per cent – need emergency readmissions every year.

But while it appears that too many people have been discharged from hospital too soon, the reasons are complex and it is as yet unclear exactly what the financial deterrent will be.

Nigel Edwards, the policy director of the NHS Confederation, said an arrangement along the lines of a "manufacturers' warranty", guaranteeing the work done for 30 days, might be workable, but fines would be far more complicated.

"Many of these patients have multiple conditions," he said. "It is difficult working out which of the conditions has brought them back. The initial diagnosis might have been heart failure, but it could be their respiratory condition causing them problems."

Under the plan, hospitals will lose money for each patient who has to be readmitted because of sub-standard treatment. The hospital will not be paid for subsequent treatment.

At present, hospitals receive a fixed fee for different treatments and care of patients once they have left hospital is placed in the hands of GPs.

Lansley said in a statement today that the government was "sending a clear message that patient care doesn't end when patients walk out of the hospital door". He said: "Over the last 10 years, emergency readmissions have increased by 50%. Not primarily because patients were more frail, but because hospitals have been incentivised to push people out early – process targets creating risks for patients.

"So we are going to ensure that hospitals are responsible for patients not just during their treatment, but also for the 30 days after they've been discharged. If a patient is readmitted within that time, the hospital will not receive any payment for the additional treatment – they will be focused on successful initial treatments."

The proposals are billed as a “revolution” in the provision of care by the NHS. Several officials are already thought to have clashed with Mr Lansley over the scale and speed at which he intends to introduce the new system. Officials are being given just a month to draw up the legislation and have been told to stop “strategising” and concentrate on introducing the new system.

The NHS is one of the few areas of government spending to be protected from the forthcoming cuts.

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