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Views & Reviews Acute Perspective

David Oliver: Stop blaming patients for emergency visits

BMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h6119 (Published 13 November 2015) Cite this as: BMJ 2015;351:h6119

Rapid Response:

Focus on Flow

Editor

I agree with everything Stephen Black says. I practise what he preaches in a unit that has consultant geriatricians at the front door of the hospital 12 hours a day 7 days a week, working with OTs and the Red Cross till 9.30pm, with rapid assessment clinics as alternative to admission, with community in reach and rapid response teams and with a concerted focus on discharge planning (fori instance two very focussed MDTs a day on my home ward and real time on line dicharge dates, delay moniitoring, etc). I also work for ECIST going into numerous hospitals giving free advice by experienced NHS staff for NHS staff grounded in an understanding of the job. And I have often highlighted key examples of good work on flow.

I have written extensively about the importance of dicharge planning. The difficulty sometimes with my "acute perspective" column is that is is quite deliberately 450 words long and no longer and so it can't be a densely referenced treatise or manual. Perhaps if he reads "making health and care systems fit for an ageing population" which I and colleagues wrote for the King's Fund and is around 35 times the length of my BMJ column or watches my youtube film "Mrs Andrews what went wrong?" he will see that I am on the same page.

But short punchy columns covering one issue are just that.

David Oliver

Competing interests: No competing interests

15 November 2015
David Oliver
Consultant Physician
Sulhamstead
Berkshire