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There’s no evidence that 25% of hospital patients would be better off cared for out of hospital

BMJ 2012; 344 doi: (Published 25 January 2012) Cite this as: BMJ 2012;344:e587
  1. Kenneth G Taylor, consultant physician
  1. 1Birmingham
  1. kandgtaylor{at}

The NHS Confederation recently said that one in four hospital patients would be better off being looked after in the community (BMJ 2011;343:d8336). The subject was covered on Radio 4’s Today programme and was followed by an interview with Michael Farrar, chief executive of the confederation.

He repeated this controversial statement to the interviewer and I waited for the fundamentally important next question: “Where is the evidence?” But the question was never asked. Instead the statement was accepted as fact. I also waited to learn whether people better informed than Mr Farrar were to give their opinions. A statement without evidence is no more than an opinion, and if we are to have opinions then they should be grounded on a foundation of evidence or personal experience. Perhaps somebody from the Royal College of Physicians or the Royal College of General Practitioners would be invited to contribute? Sadly this was not the case.

Mr Farrar was treated as the only source of information and an expert on the subject—an exalted position for a health service manager. I suspect he was espousing current thinking from the …

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