Views & Reviews Personal View

Care homes shouldn’t profit from delays in assessing their residents for discharge from hospital

BMJ 2011; 343 doi: (Published 12 October 2011) Cite this as: BMJ 2011;343:d6570
  1. David Bryson, orthopaedic senior house officer, Kettering General Hospital, Kettering, UK
  1. davidjbryson{at}

Twenty two days in a side room on an acute orthopaedic ward. Twenty two days alone with the same four walls, with no television and no visitors. The admission could have been—and should have been—shorter. The patient was ready to return home on the 16th day after the operation, 17 days after admission, but his discharge was delayed for a further five days. What was the reason for the delay? We had to wait four days for the manager of the residential home to come and assess the patient’s suitability to return to their care.

Such a scenario will come as no surprise to those who work on acute medical and surgical wards. What may be a surprise—it certainly was to me—is that the residential home continues to receive 100% funding throughout the admission and does so for all admissions up to four weeks’ long. Assuming the funding is not private, this means that the government and tax payers are effectively paying twice for the delivery …

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