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Report shows lung disease patients are discharged from hospital too soon

7th December 2010

British Lung Foundation and British Thoracic Society calling for greater involvement from respiratory physicians.

A new report being launched today by the British Lung Foundation (BLF) and British Thoracic Society (BTS) reveals a shocking 75% of patients with a chronic lung disease feel that they were discharged from hospital too early with the majority (84%) feeling that they wouldn’t be able to cope when they got home. Alarmingly, the report also found that only 53% of patients were seen by a respiratory specialist before discharge and only 32% of hospitals actually use a formal discharge checklist.

The ‘Ready for Home?’ report, which launches at the BTS Annual Winter Meeting in London today, has been developed to improve the support and care given to people living with Chronic Obstructive Pulmonary Disease (COPD), an umbrella term for chronic bronchitis and emphysema. Together the BLF and BTS conducted surveys with COPD patients and healthcare professionals which formed the findings and recommendations in the report.

People living with COPD are often admitted to hospital after experiencing a flare-up of their condition where symptoms, including breathlessness, can worsen. These flare-ups are often extremely distressing for the patient and are a significant cause of hospital admission, readmission and substantial healthcare costs. Recent data has shown that the rate of readmission following hospitalisation for a flare-up is increasing, with one in three people with COPD now being readmitted within 28 days of discharge.

As a result of the surveys, work will begin early next year to produce a discharge checklist. This will focus on improving the support given to patients before they leave hospital; improving COPD patients’ and carers’ understanding of flare-ups; and improving the consistency of care across all hospitals through the UK.

Encouraging patients to stop smoking is one of the best ways to manage and prevent COPD. To make sure that all patients are getting advice on quitting, BTS is launching the ‘Smoking Cessations Champion Project,’ an initiative which will encourage every UK hospital to internally recruit a specialist to oversee, introduce or improve aspects of patient care and hospital administration related to helping patients to stop smoking.

COPD is a preventable, progressive and life-limiting disease, which as the UK’s 5th biggest killer, claims more lives than breast, bowel or prostate cancer. The disease is the second most common cause of emergency admission to hospital and the fifth largest cause of readmission. Previous research shows that the majority of hospital admissions for COPD are unscheduled and, as such, present a high burden of cost to the NHS.

Dame Helena Shovelton, Chief Executive of the British Lung Foundation, said: “For COPD patients, flare-ups are a worrying and frightening experience and patients often say that it feels as if they are drowning or suffocating because their breathing is so difficult. From our research we have found that this distress often continues when the patient is discharged from hospital too early and they feel they can’t cope at home. We want patients to be given the care they need to be able to comfortably return home and manage their condition, minimising the risk of another flare-up.

“In addition to this, the facts clearly show that COPD hospital admissions are often unplanned and therefore costly to the NHS. We wanted to produce this report to ensure that the discharge care available is improved, to limit the amount of readmissions, which puts a further strain on the healthcare system.”

Professor Mike Morgan, Chairman of BTS said: “It’s frustrating to see that despite respiratory diseases causing more deaths than heart attacks each year, still not enough is being done to support COPD patients in our hospitals. You wouldn’t expect a cardiology patient to leave hospital without seeing a cardiologist, the time has come to place as much emphasis on COPD.

“The evidence is clear – intervention from a respiratory physician can prevent flare ups and can reduce readmissions – surely a good thing for both patients and the NHS. Respiratory specialists need to be involved in the whole patient process, from commissioning to diagnosis and management of conditions Something must be done, all patients should be seen by a specialist physician before being discharged from hospital.”

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