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Audit shows majority of patients at the Royal had no need to be there after seven days

An audit of patient discharges at the Royal Victoria Hospital in Belfast has shown most could be released much earlier.
Gareth McKeown

AN audit of discharges at the Royal Victoria Hospital in Belfast has shown the majority patients had no need to be in hospital after seven days and could have been released much earlier.

Carried out by the Health and Social Care Board the 'daily profile' shows how 35 patients contributed to a total of 1154 bed days last year.

The sample revealed that by day four 30% of the 33 patients still in hospital had no criteria for an acute bed. By day 10 a whopping 70% of the same 33 patients had no criteria.

By 16 days, almost half way through the review 30 patients of the initial 35 remained in hospital and 87% of these did not meet the criteria for a bed.

Throughout the review process the overall percentage of patients with no criteria increased with their length of stay in hospital.

The Health and Social Care Board's audit, received by the Belfast Local Commissioning Group last month, has raised a number of key issues.

The report states that many patients rarely saw a senior clinician, while 35% saw none. It further recognised how most patients had no need to be in hospital after seven days and could be discharged much earlier.

In terms of assessment and care planning for complex patients the audit found that this could begin much earlier and outside hospital, while the board said that "focused management of care with clear responsibilities" could improve outcomes.

The review also highlighted a number of issues raised by the Belfast Trust. The failings include a lack of senior decision makers in complex cases and a lack of team work between professionals, hospital staff and the community. The trust also highlighted a "conservative approach" to community risk by hospital-based staff.

The Irish News has revealed that almost 68,000 'bed days' were lost in hospitals across the north last year due to delays in discharging patients.

A bed day is defined as a day during which a patient is confined to a bed and stays overnight. At the Royal Victoria Hospital 8,840 days were lost due to such delays,

The Department of Health has confirmed the most common reasons given for complex charges to be delayed last year were: "No capacity in domiciliary care providers; care planning incomplete and no nursing home bed available."

For simple discharges the most common reasons given for delays by the department were: "Pharmacy delay in patient receiving drugs and awaiting transport from family or friends."

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