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Readmissions: Why It's a Problem in the NHS

5 minute read | 13/07/2023

Readmissions: Why It's a Problem in the NHS

Readmissions have been a longstanding problem within the NHS. Hospital readmissions is when a patient is discharged from a hospital and subsequently admitted again within a certain period, usually within 30 days. Monitoring readmission rates is important because the higher they are, the lower the quality of care, patient safety, coordination of services, and/or post-discharge support.

Learn about the top reasons for readmission and how it can be reduced.

 

The Importance of Hospital Readmission Rates

A study published in Health Watch in 2018 reported that the ‘number of people being readmitted to hospital within 30 days of discharge had grown by 22.8% over the previous five years, with one in five cases returning within just 48 hours.’   

This dramatic rise in readmissions is increasingly hindering the patient experience as they have to be in and out of hospital more. What can be done to change this to benefit both the staff and patients? 

 

Consequences to High Readmission Rates

Here are two main consequences to hospital readmission rates, financial and quality of care. This impacts NHS service improvements for both the Trust effected and the patients.  

1. Financial Impact: Readmissions impose a significant financial burden on the NHS. According to estimates, readmissions cost the NHS billions of pounds annually. The funds spent on readmissions could be utilised for other healthcare services if readmission rates were effectively reduced. 

2. Quality of Care: High readmission rates can reflect shortcomings in patient centred care during the initial hospitalisation. Factors such as inadequate discharge planning, incomplete diagnostic workup, medication errors, or complications arising from surgical procedures can contribute to readmissions. Addressing these issues is crucial to improving patient outcomes. 

 

What are the Common Reasons for Hospital Readmission?

The three main elements that cause hospital readmissions is a lack of co-ordination, discharge plans, and catering to complex patient needs. In most cases, digital technology can help mitigate these issues along with planned co-ordination. 

1. Fragmented Care and Coordination: Fragmented care, where patients receive services from multiple healthcare providers, can lead to poor coordination and communication, increasing the likelihood of readmissions. The transition from hospital to community care settings is a vulnerable period, and gaps in care, lack of follow-up appointments, and limited communication between healthcare professionals can contribute to readmissions.  

readmission

2. Discharge Planning and Follow-up: Insufficient discharge planning and limited post-discharge support are common reasons for readmissions. This involves ensuring patients receive appropriate follow-up care, medication management, and access to community support services. Companies such as Autumna help tackle this by providing a wealth of information about care homes and for the elderly.  

3. Complex Patient Needs: Many patients within the NHS have complex medical and social needs, which can increase the likelihood of readmissions. Factors such as advanced age, multiple chronic conditions, mental health issues, social deprivation, and lack of support networks contribute to readmissions. Tailored care plans and holistic approaches are necessary to address these complexities and minimise readmissions. 

There are other external factors including socio- economic deprivation experienced by the local community. Page 17 on the NHS Readmission Document highlights that in regions where the most economically disadvantaged 10% of the population resides, the rate of emergency admissions is more than twice as high compared to regions where the wealthiest 10% of the population in England live.

 

How to Reduce Readmissions

The NHS has implemented various initiatives to tackle the readmissions problem. These include enhanced discharge planning, improved communication between healthcare providers, better integration of care across different settings, and increased investment in community-based support services.  

All of these elements can be brought together by technology in healthcare. We can use technology to communicate with more communities that provide care for those recovering from hospital. This is especially prominent with the elderly. During the admission process, healthcare workers can determine what support the patient will need after their care and start implementing that before their treatment starts.  

Top tips from Nottingham University Hospital Trust include:

  • Establishment of datasets early on is crucial for better comparison.
  • Use electronic evaluation forms for easier review. 
  • Get community engagement at all levels. 

Discharge is the most important part of a patient’s journey and it starts at admission. 

 

Actions to reduce emergency readmissions

75% of patients want digital healthcare services

So let’s work together to give it to them, all while optimising NHS processes.


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