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Views & Reviews Acute Perspective

David Oliver: Why I let some patients stay longer in hospital

BMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h5225 (Published 02 October 2015) Cite this as: BMJ 2015;351:h5225
  1. David Oliver, consultant in geriatrics and acute general medicine, Berkshire
  1. davidoliver372{at}googlemail.com

I have a confession: I sometimes allow patients to stay an extra day or three in hospital, even when they’re technically stable enough to leave. I’ve spoken to many other secret transgressors, but it’s still a hard thing to admit.

Yes: I know that it’s bad. England has relatively few acute beds.1 We’ve lost them rapidly, while emergency admissions and delayed transfers have risen inexorably.2

Overcrowding hurts.3 Hospitals become less efficient and safe when bed occupancy is high.4 Four hour NHS targets for emergency departments cause huge pressure. Beds are scarce, as well as …

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