Emergency patients to stay in hospital care longer

Andrew Lansley delivers his first major speech as the new Health Secretary, at a health centre in Bromley by Bow in east London June 8, 2010.

LONDON (Reuters) - Emergency patients in England will remain in the care of state-funded hospitals for longer under plans to improve medical treatment, Health Secretary Andrew Lansley said on Tuesday.

At present patients are discharged from emergency wards into the care of local health services or family doctors.

But around one in 10 are readmitted as emergency cases, disrupting their recovery and incurring greater expense for the National Health Service.

From April next year hospitals will be responsible for the aftercare of emergency admissions and receive extra funding as a consequence, Lansley said.

However, they will forfeit any additional payments for treating patients who return as an emergency case within 30 days.

Lansley said the move would make hospital managers focus on achieving successful initial treatments.

"It will be in the interests of the hospital for patients to be discharged only when they are ready and safe to do so," he said.

Under the current system NHS hospitals are paid for each emergency patient treatment, even if that patient has to return many times, a situation Lansley said was "perverse."

"Over the last 10 years, emergency readmissions have increased by over 50 percent," he said, in a criticism of health policy under the former Labour government.

"Not primarily because patients have become more frail, but because hospitals have been incentivised to cut lengths of stay and send patients home sooner."

Emergency readmissions rose from just under 360,000 to around 546,000 cases between 1998 and 2008, the health department said.

Lansley, a Conservative Party member of the coalition government, wants the NHS to concentrate on the outcome of a patient's treatment rather than on the short-term targets favoured by Labour.

"I am going to ensure that hospitals are responsible for patients not just during their treatment in hospital, but also for the 30 days after they've been discharged," Lansley said.

"The outcome for patients is the only outcome that matters. We will be sending a clear message to the NHS that patient care doesn't end when they walk out of the hospital door."

Doctors warned the change could have unintended consequences. Hamish Meldrum, chairman of the British Medical Association, said fears over financial penalties could lead to patients being kept in hospital longer than necessary.

"One risk is that we get a situation where decisions about discharge are based not on a judgement about what is best for the patient, but on an attempt to avoid additional costs," Meldrum said.

The Conservative-Liberal coalition has pledged to ringfence health spending from the steep cuts across government needed to repair a budget deficit of around 11 percent of gross domestic product.

But that still means Lansley must find efficiencies within the health service budget, running at over 100 billion pounds a year, to meet rising demands for healthcare as the population ages and new treatments emerge.