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07.06.16

Delayed discharge is ‘existential threat’ to emergency medicine

Unnecessary delays in discharging patients pose an “existential threat” to emergency medicine, the Royal College of Emergency Medicine has warned after the chief executive of NHS England admitted that the problem may not be dealt with for four years.

A recent National Audit Office (NAO) report found that the problem has been severely underestimated and delayed transfers of elderly patients have increased by 31% in the past two years.

In a Public Accounts Committee hearing yesterday, Simon Stevens warned MPs that he couldn’t say when the NHS would manage to achieve 0% delayed transfers because it was “going to be battling some very substantial headwinds over the next two, three, four years”.

Dr Clifford Mann, president of the Royal College of Emergency Medicine, said: “People should be aware that this as an existential threat to the safe delivery of emergency care. The current crisis is the consequence of silo behaviours in a fragmented system.”

In a frequently fractious session, Stevens also admitted that delayed discharge was a “systematic problem” but that he couldn’t name a “single person or organisation” with oversight of the system.

He also challenged the NAO report’s accuracy, insisting that delayed discharges were “almost certainly better” than in 2003.

When asked how the Department of Health could solve the problem, Jon Rouse, director general of social care, local government and care partnerships, replied “I can’t give you that answer”.

Dr Mann also warned that “burn-out and poor retention of staff” because of pressures on emergency medicine risked making the staffing crisis even worse.

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