Patient concerns lead to evaluation of emergency hospital readmissions

NHS Digital has responded to the Healthwatch England call to monitor emergency readmission rates and investigate the reasons why people return to hospital just 30 days after they have been discharged.

In November last year research by Healthwatch England identified a significant spike in people having to return to hospital for unplanned further treatment within 30 days of being discharged.

From the 70 of the 125 hospitals across England that provided data Healthwatch England found:

• 484,609 emergency readmissions in 2017-18. This is 22% higher than five years ago.
• When this is broken down by the number of days between discharge and readmission, the research found that the numbers returning within just 24 hours rose by 33%.
• The number of overall admissions to the same 70 hospitals between 2013-14 and 2017-18 fell by 0.42%.

Over the last three years readmissions have continued to be a strong theme in the feedback Healthwatch hears.

People have said how distressing the process of repeatedly going in and out of hospital can be and the impact it can have on someone’s health and wellbeing. The research also found that people with the most complex or acute needs are often the worst affected, including older people and people receiving end of life care.

Healthwatch England said: “It is important to remember that not every emergency readmission can or should be avoided. New approaches to care mean services sometimes plan more but shorter hospital stays for some people.

“However, the lack of official data collected by the NHS has made it difficult to build a comprehensive picture of who is being affected and why they are coming back in to hospital.

“Only with access to good data can hospitals be certain they are doing everything they can to minimise preventable readmissions. This is of particular importance in areas where they are trialling new ways of treating people to ensure the impact on patients is tracked effectively and any lessons learned can be shared with other hospitals.”

NHS Digital’s decision to reintroduce and improve the emergency readmissions dataset, which has been on hold since 2013, comes in  response to the research by Healthwatch and will be seen as a positive move by those organisations and key clinicians who have joined Healthwatch in its call for action.

Responding to the announcement, Chair of Healthwatch England, Sir Robert Francis, said: “Whilst people often give glowing feedback about their experiences of hospital care, they are far less positive about their experience of the discharge process, with avoidable return trips to hospital a common theme.

“Whilst not all emergency readmissions can or should be prevented, they can cause significant distress for patients and families and so it’s vital that the NHS avoids them where possible.

“The announcement by NHS Digital therefore marks an important step, arming hospitals and community services with the data they need to identify and address the issue.

“It also highlights how Healthwatch’s commitment to ensuring people’s experiences of care are understood by policy makers is helping both patients and the NHS.

“Healthwatch could not have achieved this change alone, and I extend our thanks to all those who have helped shine a light on readmissions, from front line clinicians to national charities and think tanks.”

Read the report which looks into the reasons behind the increase in the number of people being readmitted to hospital just 30 days after being discharged here.

Read the plans to better record data for people leaving hospital and why they are readmitted here.