Concerns over Blackburn Hospital A&E department's readmission rate 'merry go round'

CONCERNS have been raised that ‘hundreds of patients are being sent home from hospital too quickly to free up beds’.

New figures show East Lancashire has some of the highest readmission rates in the UK.

They cover the number of patients admitted through emergency wards within 30 days of being discharged from hospital.

Bosses at the Royal Blackburn and Burnley General hospitals have acknowledged the need for improvement and said the reasons for the high rates are being investigated.

The readmission rates for those living in the Blackburn postcode were the third highest in the country, according to stats published by the Health and Social Care Information Centre, with the rest of East Lancashire ranked 41st out of about 200 NHS authority areas.

East Lancashire Hospitals Trust is also failing to meet a key NHS target for unplanned re-attendances at A&E, though the performance has improved slightly since last year.

Health watchdog Ron O’Keeffe said he was concerned that patients are being discharged before they are ready.

The chairman of Blackburn with Darwen’s Health Overview and Scrutiny Committee added: “The hospitals have got to look at their patients and make sure they’re ready for going home before they are sent home. There needs to be more care taken before patients are released. This is something I’m very concerned about and we’ve got to look at it.”

Hospital staff across the North West have been under severe pressure due to high levels of attendances in recent months, leading the Royal College of Nursing to raise fears for patient safety.

Among the concerns raised by the union was that some patients were being discharged too soon in a bid to vacate beds.

Blackburn MP Jack Straw said: “This is a cause for concern and I hope the hospital trust will look into it. It’s linked into the pressure on beds, which runs into the extent to which GPs are available to deal with out-of-hours work.”

Blackburn with Darwen Council’s adult care chief Mohammed Khan said: “It is becoming something of a merry-go-round of people going to A&E, being discharged and coming back.

“We need to make sure that people are being treated properly, discharged at the right time and receive the right after care. If they are not, they will be coming back to the A&E department the following day or following week needing more treatment.”

And Gordon Birtwistle, MP for Burnley, said: “I’ve been concerned about the re-admission rates for a long time, because it worries me in terms of patient safety. Obviously there’s a shortage of beds and this is why we want them to reopen large parts of Burnley General.”

Pendle Liberal Democrat Peer Lord Greaves said he would raise the issue with Earl Howe, the government health minister in the House of Lords.

He added: “We need to know whether people are being discharged too soon, not being admitted properly in the first place or whether the aftercare when they are sent home is inadequate.”

Val Bertenshaw, director of operations, said: “The trust has improved on its unplanned re-attendance rate which was 6.23 per cent in 2011/12 and is 5.50 per cent in 2012/13.

“Re-attendances to emergency department also include people with addiction problems and social issues who may not need emergency services but do not use other services available in the community.

“This differs to re-admission rates which the trust board identified as a need for improvement in its Quality Improvement Strategy. “Work streams have now been co-ordinated to manage the issues on a specialty basis with detailed investigation into why they are occurring and we are confident that this will show improvements in the near future.

“Both these indicators are measures of system health not just what happens in the hospital and we are working closely with our partners to redesign care pathways that support people in the community and provide appropriate alternatives to hospital admission.”

Comments (5)

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11:18am Wed 8 May 13

kate11 says...

Val Bertenshaw, director of operations says
" “Re-attendances to emergency department also include people with addiction problems and social issues who may not need emergency services but do not use other services available in the community.
“This differs to re-admission rates which the trust board identified as a need for improvement in its Quality Improvement Strategy. “
Here we go with the spin again always blame something else. Having worked there I know they have not sufficient beds and not enough staff with experience as they are all leaving or retiring early as they are fed up with the mis management! I am so surprised they are allowed to get away with it! Opening more beds at Burnley will not help as the Trust have to save money constantly and "work lean" so there will be staffing issues! I am also the relative of a patient who has frequent admissions due to being discharged too early! It is scandalous! Also many babies being readmitted after they are sent home too early from the Maternity unit due to lack of beds! What a waste of resources! Ask any nurse unless they are too scared to talk about it!
Val Bertenshaw, director of operations says " “Re-attendances to emergency department also include people with addiction problems and social issues who may not need emergency services but do not use other services available in the community. “This differs to re-admission rates which the trust board identified as a need for improvement in its Quality Improvement Strategy. “ Here we go with the spin again always blame something else. Having worked there I know they have not sufficient beds and not enough staff with experience as they are all leaving or retiring early as they are fed up with the mis management! I am so surprised they are allowed to get away with it! Opening more beds at Burnley will not help as the Trust have to save money constantly and "work lean" so there will be staffing issues! I am also the relative of a patient who has frequent admissions due to being discharged too early! It is scandalous! Also many babies being readmitted after they are sent home too early from the Maternity unit due to lack of beds! What a waste of resources! Ask any nurse unless they are too scared to talk about it! kate11
  • Score: 2

12:37pm Wed 8 May 13

Bryan71 says...

They have done this with my 79 year old mother sending her home at 10-30pm at night
Then back in the next day.
The complaints we have made.Nobody listens though
They have done this with my 79 year old mother sending her home at 10-30pm at night Then back in the next day. The complaints we have made.Nobody listens though Bryan71
  • Score: 1

2:03pm Wed 8 May 13

mavrick says...

It is ultimately the governments fault for cutting £20 Billion from the health budget, what can we expect, we seem to have some bad managers in the trust and a budget cut that is simply unsustainable. There are very few genuine nurses theses days, they want all nurses to have a degree, WHY? it is not necessary. when staff members hang a banner on the main entrance saying save our hospital it tells you immediately there is a serious problem. It is time for a root and branch investigation of the mismanagement of the ELHT. if you want to know the best way to do a job, ask the person doing it.
It is ultimately the governments fault for cutting £20 Billion from the health budget, what can we expect, we seem to have some bad managers in the trust and a budget cut that is simply unsustainable. There are very few genuine nurses theses days, they want all nurses to have a degree, WHY? it is not necessary. when staff members hang a banner on the main entrance saying save our hospital it tells you immediately there is a serious problem. It is time for a root and branch investigation of the mismanagement of the ELHT. if you want to know the best way to do a job, ask the person doing it. mavrick
  • Score: 1

2:08pm Wed 8 May 13

Gaius Grossus says...

I'm defending the medical staff who were magnificent with me during my 2 admissions in March. The first time I went to A&E with rapid palpitations. It was a Sunday afternoon and heaving with injured footballers, so they were not able to monitor me during the earlier part of the problem. Because of this they specifically asked me to call 999 if it happened again. 3 weeks later it did and I did as I was told. The Ambulance was at my house in a very short space of time and I was taken back to Blackburn and was monitored immediately. I cannot praise the para-medics, A&E staff or the CCU staff to highly. You do wonder if some of the management could organize the vertical urination within the precincts of Daniel Thwaites or Moorhouses
I'm defending the medical staff who were magnificent with me during my 2 admissions in March. The first time I went to A&E with rapid palpitations. It was a Sunday afternoon and heaving with injured footballers, so they were not able to monitor me during the earlier part of the problem. Because of this they specifically asked me to call 999 if it happened again. 3 weeks later it did and I did as I was told. The Ambulance was at my house in a very short space of time and I was taken back to Blackburn and was monitored immediately. I cannot praise the para-medics, A&E staff or the CCU staff to highly. You do wonder if some of the management could organize the vertical urination within the precincts of Daniel Thwaites or Moorhouses Gaius Grossus
  • Score: 1

5:58pm Wed 8 May 13

Fire Fly says...

The issue with the senior management team at this Trust is that they repeatedly appoint people not able to carry out lower grade management positions in order to save money.

They don't bother to ensure that if something is on a persons C.V. that the person concerned can actually back that up with real knowledge. Too many can talk the talk, too many have NO clinical background, too many can't use previous roles to bring anything to the current role because they were useless in that role too, But still, they get appointed!

And the result of appointing these puppets....the senior management have a bunch of yes men & women who aren't able to question whats going on. That says it all to me.
The issue with the senior management team at this Trust is that they repeatedly appoint people not able to carry out lower grade management positions in order to save money. They don't bother to ensure that if something is on a persons C.V. that the person concerned can actually back that up with real knowledge. Too many can talk the talk, too many have NO clinical background, too many can't use previous roles to bring anything to the current role because they were useless in that role too, But still, they get appointed! And the result of appointing these puppets....the senior management have a bunch of yes men & women who aren't able to question whats going on. That says it all to me. Fire Fly
  • Score: 1

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