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'We are a compassionate organisation' - James Paget Hospital on why it took two years and a court order to discharge medically fit patient who refused to leave

PUBLISHED: 18:21 20 January 2017 | UPDATED: 19:33 20 January 2017

James Paget University Hospital, Gorleston, Norfolk.

James Paget University Hospital, Gorleston, Norfolk.

©Archant 2013

A hospital trust has today defended the way it tried to discharge a patient who ended up staying unnecessarily on a ward for more than two years.

In an extremely unusual case - the James Paget University Hospitals NHS Foundation Trust said it was a “compassionate organisation”, after spending much time and resource trying to discharge a male patient who refused to leave.

The disbaled patient, who cannot be named, was admitted to the James Paget Hospital in Gorleston on August 21, 2014.

He was declared fit for discharge just a few days later, but refused to leave.

The hospital trust and social care partners offered “appropriate accommodation” on several occasions, but the patient would not budge.

As a last resort, the trust said it had to apply to the court to Norwich County Court to allow it to remove the patient from the hospital.

The application was made to the court last autumn, and permission granted on December 1. The patient was then evicted on January 10. He was moved to accommodation in the community.

However while the patient repeatedly refused to leave the hospital, the legal position is that a patient does not have the right to refuse discharge.

The Department of Health estimates that the average daily cost of a hospital bed is about £400, meaning that the patient’s stay at the hospital would have cost about £340,000 in total.

A spokesman for the trust said: “As a compassionate organisation, we wanted to work with the man and his friends and family on his discharge from hospital and were hopeful that this could succeed.

“Only after several failed attempts did it become clear that our efforts to reach a reasonable conclusion would not prove successful – and, with reluctance, we had to resort to court action.”

Anna Hills, the trust’s director of governance, added: “The gentleman had been occupying a bed unnecessarily at the James Paget University Hospital for more than two years – and every effort had been made to try to remedy this situation.

“The decision to go to court was not taken lightly but our priority has to be considering the needs of all our patients and ensuring that our limited resources, which are under increasing pressure, are available to those who genuinely need hospital care.

“The gentleman continues to receive the appropriate level of care and support in the community.”

It comes at a time when demand for hospital beds are at record levels, with delayed discharges estimated to cost the NHS around £900m per year.

However nearly all delayed discharges, unlike this case, occur because a package of care for patients has not been put in place outside hospital by NHS trusts and social care authorities.

Analysis by Nicholas Carding, health correspondent

This is a very unusual case which is a little more complex than one might think.

The context - by contrast - is pretty clear.

Delayed discharges are a major problem for hospitals, with a clear increase occurring in the last few years.

At a time when there is record levels of pressure for hospital beds, the need for chiefs to discharge patients as fast as possible has never been bigger.

This makes the story that unfolded at the James Paget Hospital even more surprising.

To be clear - a patient does not have the right to refuse discharge.

But hospitals, as all organisations in the NHS, have a duty of care to their patients.

Paget managers have commendably taken that duty very seriously in this particular case.

They offered the patient several opportunities to be discharged to a suitable place of care. He refused each one.

While it is positive to see a hospital go to many lengths to satisfy the patient, the tax-payer can rightly ask why so much money was spent on a person who required no treatment and was deliberately obstructing a system under huge pressure.

The Department of Health has been contacted but have not yet provided a response.

Have you got a hospital story?

Email nicholas.carding@archant.co.uk

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