Skip to main content

Reducing readmissions to hospital.


Reducing readmission of patients to hospital after their initial discharge is a priority for many health systems because of the considerable public health impact and financial cost of these readmissions. For example, in England, there are around 535 000 readmissions annually in patients aged 16 years or older. About 11.2% of hospital admissions result in readmission, and there is a wide variation between both general practices and primary care trusts. I discuss the experience of England in this area in a publication in the Annals of Internal Medicine. A number of initiatives have aimed to reduce hospital readmissions in England but their success has generally been limited. The most recent initiative - the success of which remains to be assessed - is to give general practitioners more control of NHS budgets. Giving physicians collective responsibility for health service budgets in their locality in an attempt to improve the efficiency of a health system  is a radical step and one that we should observe closely to learn about the benefits and also to identify any unintended adverse consequences.

Comments

Popular posts from this blog

MPH Student Presentations on the NHS Care.Data Programme

As part of a session on primary care data in the Health Informatics module on the Imperial Master of Public Health Programme, I asked students to work in two groups to present arguments for and against the NHS Care.Data programme. Care.Data is an NHS programme that will extract data from the medical records held by general practitioners (GPs) in England. The Care.Data programme takes advantage of the very high level of use of electronic medical records by GPs in England. After extraction, data will be uploaded to the NHS Health and Social Care Information Centre (HSCIC). The data will then be used for functions such as health care planning, monitoring disease patterns and research. The programme has been controversial with proponents arguing that the programme will bring many benefits for the NHS and the population of England; and opponents arguing it is a major breach of privacy. You can view the two presentations to help inform you further about these arguments: Arguments fo...

The Hidden Cost of Cheaper NHS Contracts: Losing Community Trust

NHS budgets are under considerable pressure. It is therefore unsurprising that many NHS Integrated Care Boards (ICBs) In England will aim to prioritise price in contract awards, But this approach is a significant threat to community-centred healthcare. While competitive tendering is a legally required, an excessive focus on costs in awarding NHS contracts risks overshadowing key factors such as established community trust, local expertise, and the long-term impact on continuity of care. This shift towards cheaper, often external, commercial providers threatens to cut the links between communities and their local health services. The argument that competitive tendering is solely about legal compliance, and not cost, is undermined by the very nature of such tendering, which by design encourages the lowest bid. This approach risks eroding the social fabric of local healthcare provision, where established relationships and understanding of specific community needs are essential. Establishe...

Talking to Patients About Weight-Loss Drugs

The use of weight-loss drugs such as GLP-1 receptor agonists (e.g., semaglutide, tirzepatide) has increased rapidly in recent years. These drugs can help some people achieve significant weight reduction, but they are not suitable for everyone and require careful counselling before starting treatment. By discussing benefits, risks, practicalities, and  uncertainties, clinicians can help patients make informed, realistic decisions about their treatment. Key points to discuss with patients 1. Indications and eligibility These drugs are usually licensed for adults with a specific BMI. They should be used alongside lifestyle interventions such as dietary change, increased physical activity, and behaviour modification. 2. Potential side effects – some can be serious Common adverse effects include nausea, vomiting, diarrhoea, and abdominal discomfort. Less common but more serious risks include gallstones, pancreatitis and visual problems. Patients should know what to watch for a...