Hospitals warned not to send elderly NHS patients home at night But in his letter to the medical directors of England's ten strategic health authorities, sent on Friday, Sir Bruce said it was clear procedures needed to change. "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," he wrote. Discharge or care transfer is of course an essential part of care management in any setting. It ensures that health and social care systems are proactive in supporting patients and their families and carers to either return home or transfer to another setting. It also ensures that systems are using resources effectively. He added: "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. NHS managers told The Times, which first reported the statistics, that "tough questions" clearly needed to be asked while campaigners said it was a "sad indictment" that such a review was even needed. . "We have got to get to the bottom of this issue," said David Stout, deputy chief executive of the NHS Confederation, which represents managers. In order to do that we will need information to be collected consistently across organisations. However, what is critical is making sure hospitals are confident that their arrangements for discharging patients and getting them home are both appropriate and safe. Katherine Murphy, chief executive of the Patients Association, added to the newspaper: "While we applaud his sending this letter, we would question why NHS managers are doing it in the first place. It's a sad indictment that we're having to remind senior professionals that it's unacceptable behaviour. They shouldn't need reminding about caring.