NHS patients 'should not face constant moves'

Hospital ward Patients often face multiple moves around hospital

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The era of NHS patients being shunted around hospitals needs to end, an expert group says.

The Future Hospital Commission - set up by the Royal College of Physicians - said a radical revamp in structures was needed to bring care to the patient.

This was particularly true for frail people with complex needs, who often faced multiple moves once admitted to hospital, the report said.

It also recommended closer working with teams in the community.

The commission said this could involve doctors and nurses running clinics in the community and even visiting people in their own homes - as is already happening in a few places.

'Bold and refreshing'

It also called for an end to the concept of hospitals discharging patients.

Sir Mike Rawlins: "Hospital shouldn't stop at the walls of the building"

Instead, it argued that many of those seen in hospitals in the 21st Century needed ongoing care that did not end when they left hospital.

So the report recommended that planning for post-hospital care should happen as soon as someone is admitted.

Key to that will be a new hub that should be created in every hospital, called a clinical co-ordination centre, which would act as a central control room, helping to ensure information about patients is shared and their care planned properly.

Once in hospital, patients should not move beds unless their care demanded it, the report said.

That contrasts with the multiple moves many patients with complex conditions often find themselves facing as they are passed from specialism to specialism.

It said this would require a greater emphasis on general wards with specialists visiting patients rather than the other way round.

Case study

The longest Suzie Hughes, who has the auto-immune condition Lupus, has spent in hospital is 21 days.

During her stay, she was moved five times for non-clinical reasons.

"I would find myself being wheeled down the corridor with my flowers and chocolates. Nurses would be with me and I kept thinking, 'What a waste of their time.'

"And each time I arrived on a new ward I had to explain my condition again. The information does not get passed on and it results in delays."

The authors - drawn from across the NHS and social-care spectrum - also called for an end to the two-tier weekday and weekend service in many facilities.

They even said it would be preferable to work at 80% capacity across the seven days if extra resources were not available in the short-term.

Commission chairman Sir Michael Rawlins said it was about providing the care patients "deserved".

Alzheimer's Society chief executive Jeremy Hughes said too often hospitals were stressful places with patients being moved "from pillar to post".

"We need nothing less than a revolution... in order to ensure our NHS is fit for the future," he added.

Health Secretary Jeremy Hunt said the report was "bold and refreshing".

"I agree completely that we must make services more patient-centred both inside and outside hospital."

Shadow health secretary Andy Burnham said: "We must turn this system around and help support people where they want to be - at home with their family around them."

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