Tuesday, May 22, 2012

Bouncing Discharges show that Virtual Wards are Dangerous & Can Kill

Get used to the phrase "virtual ward". It means caring for yourself at home. The government have come up with this innovation as a way of saving money in our NHS. They shut down wards in hospitals, reduce bed numbers and have less need to hire as many staff. The idea is that if they educate you well enough you can manage your own illness. Privately NHS staff are contacting me to express a worry about the drive.

There are two major developments that suggest this is bonkers.

1. As the link (click here) shows for Royal Hospital in Bath, up to 1 in 8 patients who are discharged actually bounce for a whole host of illnesses. This means they have to be readmitted to the hospital. In the month of December 2011, this included nearly 16% of Cardiac Patients. If you're not happy being sent home do not let them pressure you into acquiescing to early discharge.

2. A crucial pilot study of US patients (COPD) self care in the home had to be abandoned because it resulted in a spike in deaths. It was calculated that a patient was 3 times more likely to die if they were sent home to treat themselves. If there is an increased chance of death from early discharge with COPD, then logic surely dictates that there is an increased risk with other conditions including cardiac complaints. I suspect this will do nothing to curtail the growth in "virtual wards" but it is something we should all play close attention to (see that report here).

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