NHS hospital night discharges: Sir Bruce Keogh's letter in full You will have seen the reports in the media this week - based on responses to a Freedom of Information (FoI) request from the Times - indicating that some patients are being discharged from hospital between 11pm and 6am. While some patients may of course choose to be discharged during these hours, the examples highlighted of elderly patients being left to make their way home by themselves in the middle of the night are obviously unacceptable, and need to be addressed urgently. It would appear from the media reports that NHS Trusts followed a number of different approaches when responding to the FoI request. For example, I understand that some analyses included 'self-discharges', 'deaths and discharges' and patients in 'assessment units' in their responses, while others focused on 'discharges' only. Whilst these different approaches make 'like for like' comparisons of this particular set of data difficult, the challenge to the NHS is absolutely clear - that patients should only be discharged when it is clinically appropriate, safe and convenient for them and their families. I would therefore like you to approach those Trusts within your SHA area who responded to the FoI request and ask them to review their analysis and practices, in the light of what could reasonably be expected of them, in line with established good practice. A similar request to review practices should also be directed to those Trusts who did not respond to the FoI request. It is important that Trust Boards take ownership of this issue, so I would expect Medical Directors, working with their Nursing Director colleagues, to ensure that the findings of their reviews are reported to their Boards at the earliest opportunity. The issues highlighted by the recent media reports are central to the drive to put quality at the heart of the NHS. As health professionals we all agree that patients should be treated with compassion, so it is simply not acceptable to send people home from hospital late at night when they may have no family members nearby to support them. I would like your assurance that appropriate arrangements are in place in all NHS Trusts to ensure timely discharge and care transfer for all patients, and I expect to discuss the outcome of the actions I have requested when we next meet on 8 May. Professor Sir Bruce Keogh