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Leaked memo at hospital trust raises alarm

BMA to contact GMC over fears of harm

Jo Carlowe

Wednesday, 15 January 2020

The British Medical Association is writing to a hospital trust to express concern after a leaked memo suggested patients should be discharged early to ease pressure on services.

In the internal memo seen by the BBC, senior staff at the Royal Cornwall Hospital Trust appeared to admit that some patient may come to harm if discharged early under plans to ease ‘significant pressure’ on services.

According to the BMA, the memo stated that early discharges “would be a proportionate risk that we as a health community were prepared to take, on the understanding that there is a possibility that some of these patients will be readmitted or possibly come to harm.”

Responding to the memo, Dr Chaand Nagpaul, BMA council chair, said the Association was writing to the trust to express ‘serious concern’ and that the BMA would also reach out to the General Medical Council.

“The BMA has repeatedly warned that the NHS has been woefully underfunded for over a decade, and this has resulted in an understaffed service with inadequate numbers of beds and facilities. Just last week we heard that December marked another record low for NHS performance – with one in five patients waiting longer than four hours in A&E, and 12,000 waiting more than 12 hours for a bed,” said Dr Nagpaul.

He added: “In the face of these pressures, this example highlights the frankly unacceptable situation doctors are facing on the ground, being pressured to discharge patients earlier than is clinically appropriate – putting both themselves and patients at risk – due to a lack of capacity and unprecedented demand.

“This is a dire indictment of the state our NHS has been allowed to creep into.

“Doctors’ primary professional duty is to make the care of their patient their first concern. They must treat the patient in front of them, based on their individual clinical needs, and doctors should never be coerced to go against their expert and considered judgement.”

Dr Nagpaul continued: “We are writing to the trust to express our serious concern and we are ready to support any doctor who refuses to compromise their care to patients. We are also reaching out to the GMC.

“As the trade union representing all doctors and medical students in the UK, we urge any members who are worried about receiving such a message, either at this trust or elsewhere, to seek advice from their medical defence organisation as well as from the BMA2 so that they can receive support on the ground."

A Cornwall & Isles of Scilly Health & Care Partnership spokesperson told OnMedica: “Our doctors, nurses and other frontline staff are working exceptionally hard to care safely for the much higher number of older and sicker patients who need our health and care services this winter.

“Nobody will be discharged if they still need care that can only be provided in hospital, but for lots of people it is far better for their physical and psychological wellbeing, and far more convenient for them, to recover at home or in a community setting with the right support, which also means that beds are available for those who need them more.

“The Royal College of Physicians agrees that ‘For patients in hospital, if they can be safely supported at home and their treatment and recovery continued there, this should occur as soon as possible. This means that other patients can get hospital care who might otherwise have to wait and be at risk of worse outcomes.’”

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