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

What is the difference between primordial prevention and primary prevention?

Primordial prevention and primary prevention are both crucial strategies for promoting health, but they operate at different levels. Primordial prevention aims to address the root causes of health problems and improve the wider determinants of health. It focuses on preventing the emergence of risk factors in the first place by tackling the underlying social, economic, and environmental determinants of health. This involves broad, population-wide interventions such as: Policies that promote healthy food choices: Think about initiatives like taxing sugary drinks to discourage unhealthy consumption, or providing subsidies for fruits and vegetables to make them more accessible. Urban planning that prioritises well-being: This could include creating walkable neighborhoods with safe cycling routes, ensuring access to green spaces for recreation and relaxation, and designing communities that foster social connections. Social programs that address inequality: Initiatives aimed at reducing pov...

UK Covid-19 Inquiry - The Importance of a Strong Primary Healthcare System

In my witness statement for Module 10 of the UK Covid-19 Inquiry, I discuss the pandemic's impact through from the perspectives of  primary care and public health, drawing on my extensive experience as a senior academic at Imperial College London and as a practising GP and NHS Public Health Specialist.  I emphasise that the pandemic disproportionately affected people who were clinically vulnerable, the disabled, ethnic minority communities and those living in deprived areas. The pandemic highlighted how structural inequalities, multigenerational housing, and employment in high-risk frontline roles exacerbated health disparities.  My statement also critiques the weakening of public health infrastructure - particularly for the control of infectious diseases - and the lack of integrated health data systems to identify at-risk groups such as the clinically vulnerable. I also advocated for a more robust preventive healthcare model that prioritises community-based primary care ...

New NHS community mental health centres in England

The Government has announced it will create over 100 new community mental health centres across England, which will work alongside GPs and other NHS organisations/ The centres will offer offer walk-in support as well as seeing patients referred from elsewhere in the NHS. GPs have long called for faster access to specialist mental health support for patients, so the expansion of community mental health services is a welcome development. If these new centres improve access to multidisciplinary teams, reduce waiting times and provide more integrated care, they can improve patient outcomes while reducing pressure on both general practice and specialist mental health services. Close collaboration between GPs, mental health professionals, social care and the voluntary sector will be essential because many people with mental health problems also have wider social and physical health needs. The success of these centres will depend on how they are implemented. They need to be adequately staffe...