Failed discharges from hospital (FOI)

Request

I am looking into "failed discharges" from the hospital and would like to know the answers to the following questions:

A

How many patients returned to hospital within 7 days of being discharged over the past three years including 2022 so far?

Could this be broken down into age group and department?

B

Whose responsibility is it to make the decision to discharge patients? (What role or roles within the hospital)?

C

What are the qualifications of those who make the decisions to send people home?

D

What protocol exists to assess a patient is fit for discharge? (What questions are asked?)

E

What support is available once they leave?

F

How many occupational therapists have there been working in Jersey from 2018 year by year to 2022?

G

How many complaints have there been from islanders who feel they, or their loved ones have been discharged too soon?

Could this be broken down by year?

H

Could you break down by month the number of total hospital beds compared to available beds over the past three years?

Response

A

The table below shows total figures for patients returning to hospital within 7 days of discharge for the last three years, broken down by age range and ward category. 

The analysis uses emergency inpatient admissions to Jersey General Hospital (JGH) only. Day units, Maternity and patients admitted under an Oncology or Obstetrics speciality have been excluded, as patients in these areas and specialities regularly require emergency admission. Admission within seven days of a previous discharge does not implicitly reflect a failed discharge.

A re-admission is counted even if the patient is admitted to a differing ward or speciality than the first admission, i.e., discharged from Medical, but re-admitted to Surgical. The ward category is the re-admitting ward and not the original discharge ward.

Where numbers are small, disclosure control has been applied to protect the privacy of individuals and numbers fewer than five are represented as ‘<5’. Article 25 of the Freedom of Information (Jersey) Law 2011 has been applied.

B

Each patient has a named consultant who is responsible for deciding if a patient is medically safe for discharge. When considering and implementing discharge, participation and input from the wider multi-disciplinary team (MDT) is required to facilitate discharge.

C

As per the answer to question B, the decision to discharge involves members of the whole MDT with a range of qualifications.

D

This is patient specific and involves a range of parameters such as medical status, therapy status and social situation status.

E

This is dependent on each individual patient and the outcome of assessments undertaken.

F

The table below shows the Full Time Equivalent (FTE) post occupancy in Occupational Therapy at end of year for 2018 and 2019.

Occupational Therapy staffing figures for 2020, 2021 and 2022 have been provided in response to previous Freedom of Information requests and are available on www.gov.je:

Hospital Physiotherapists and Occupational Therapists (FOI)

Health and Community staff employed and pay scales (FOI)

As this information is available elsewhere, Article 23 of the Freedom of Information (Jersey) Law 2011 has been applied.

G

Health and Community Services (HCS) have recorded 13 complaints made by individuals who feel they or their loved ones were discharged too soon from January 2018 to end October 2022 (inclusive).

Historically, a subject field has not been available to identify complaints specifically related to early discharges, or other synonymous subject criteria. As such, the complaints database was searched using the keyword ‘Discharge’ to identify complaints that may fall in scope of this Freedom of Information request within the specified timeframe. Each of these records was then scrutinised to confirm whether the complaint related to concerns regarding a patient being discharged before they or their relatives felt was appropriate.

Due to small numbers, HCS are unable to provide a further breakdown of these figures by year as it may lead to the identification of individuals and breach the confidentiality of their personal information. Therefore, Article 25 of the Freedom of Information (Jersey) Law 2011 has been applied to protect the privacy of individuals.

H

The table below details total beds and bed availability for JGH and Overdale Hospital, represented by bed days per month. Day Units, Oncology and Maternity wards have been excluded.

‘Available Bed Days’ is the sum of bed days per month for all opened beds, inclusive of occupied beds.

Table.pdf

Articles applied

Article 23 - Information accessible to applicant by other means

(1) Information is absolutely exempt information if it is reasonably available to the applicant, otherwise than under this Law, whether or not free of charge.

(2) A scheduled public authority that refuses an application for information on this ground must make reasonable efforts to inform the applicant where the applicant may obtain the information.

Article 25 - Personal information

(1) Information is absolutely exempt information if it constitutes personal data of which the applicant is the data subject as defined in the Data Protection (Jersey) Law 2005.

(2) Information is absolutely exempt information if –

(a) it constitutes personal data of which the applicant is not the data subject as defined in the Data Protection (Jersey) Law 2005; and

(b) its supply to a member of the public would contravene any of the data protection principles, as defined in that Law.

3)      In determining for the purposes of this Article whether the lawfulness principle in Article 8(1)(a) of the Data Protection (Jersey) Law 2018 would be contravened by the disclosure of information, paragraph 5(1) of Schedule 2 to that Law (legitimate interests) is to be read as if sub-paragraph (b) (which disapplies the provision where the controller is a public authority) were omitted.