Health professionals tend to a patient in a hospital bed

Emergency measures set to allow hospitals to discharge patients early

Emergency measures are expected to be utilised by health chiefs in the coming weeks to begin discharging early thousands of hospital patients, for who it is deemed safe enough to do so, to either their own homes, or in some circumstances hotels which have been commissioned out by the health service.

By discharging patients early, where appropriate, it will help under pressure hospitals around England free up both bed capacity and, crucially, the necessary staff to manage them for Covid-19 patients requiring urgent care.

The Guardian reported seeing documents which suggested hospital chiefs in England would soon look to begin discharging patients early on a previously unseen scale, as part of an emergency measure to create “extra emergency contingency capacity” and prevent parts of the NHS from being overwhelmed.

There is also understood to potentially be a view to working with care homes to discharge some patients into their care, as well.

In London, some NHS trusts have also began working with local hotel groups to see the latter accept Covid-positive patients who are homeless.

Under NHS regulations, a person cannot be discharged from hospital without a suitable place to go - be that their own home, into the care of family or carers or into another, alternative care environment. This can lead to some patients being difficult to discharge safely and further restrict usable hospital capacity.

Across the country a number of hospitals and NHS trusts have seen significant increases in the number of Covid-19 patients needing urgent treatment being admitted, straining capacity and leading to the cancellation of many elective and non-urgent surgeries and treatments to help minimise their inpatient numbers.

Chris Hopson, Chief Executive of NHS Providers said: "Pressures on the NHS have reached a point where we need to urgently identify additional capacity – beyond hospitals and NHS community service beds - to ensure newly arriving patients get the care they need.

"We know that in some places acute hospitals, and NHS community services are now reaching full capacity, including surge capacity.

"We need more beds, and with the right NHS clinical support and government financial support, there is a potential opportunity to use care and nursing homes and extra social care at home for that additional bed capacity.

"There is, of course, no question of using this capacity for patients who could introduce Covid-19 infection risk into care homes or for patients requiring complex or specialist hospital care.

"But we understand from trust leaders that, in some areas, there is extra available capacity in the care sector that could be accessed if the NHS, local and national government and the care sector acted at pace as though we are in an emergency situation. This is where trust leaders in London, the South East and the East of England now feel they are. But they recognise the NHS, clinically, and the government, financially, need to support the care sector.

"The government needs to provide extra financial incentives and support for the care sector to open up any spare capacity they have on the basis that this is now becoming an emergency. This could also mean additional funding for domiciliary care which social care colleagues tell us is key. The NHS needs to consistently provide clinical and therapy support where needed, for example by treating any beds with higher acuity discharged hospital patients as extended community beds.

"This will require rapid, effective, working at local level, supported nationally, but unless we act in the next few days, we will have missed what many trust leaders feel is a vital opportunity to maximise outcomes for the greatest number of people."

National Health Executive, Jan/Feb, Cover

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