Download PDFPDF

Could the rise in mortality rates since 2015 be explained by changes in the number of delayed discharges of NHS patients?
Compose Response

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g.
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Statement of Competing Interests


  • A rapid response is a moderated but not peer reviewed online response to a published article in a BMJ journal; it will not receive a DOI and will not be indexed unless it is also republished as a Letter, Correspondence or as other content. Find out more about rapid responses.
  • We intend to post all responses which are approved by the Editor, within 14 days (BMJ Journals) or 24 hours (The BMJ), however timeframes cannot be guaranteed. Responses must comply with our requirements and should contribute substantially to the topic, but it is at our absolute discretion whether we publish a response, and we reserve the right to edit or remove responses before and after publication and also republish some or all in other BMJ publications, including third party local editions in other countries and languages
  • Our requirements are stated in our rapid response terms and conditions and must be read. These include ensuring that: i) you do not include any illustrative content including tables and graphs, ii) you do not include any information that includes specifics about any patients,iii) you do not include any original data, unless it has already been published in a peer reviewed journal and you have included a reference, iv) your response is lawful, not defamatory, original and accurate, v) you declare any competing interests, vi) you understand that your name and other personal details set out in our rapid response terms and conditions will be published with any responses we publish and vii) you understand that once a response is published, we may continue to publish your response and/or edit or remove it in the future.
  • By submitting this rapid response you are agreeing to our terms and conditions for rapid responses and understand that your personal data will be processed in accordance with those terms and our privacy notice.
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

Other responses

Jump to comment:

  • Published on:
    A chicken and egg conundrum
    • Rodney P Jones, Statistical Advisor Healthcare Analysis & Forecasting

    This paper is a welcome addition to attempts to explain the effects of the increased deaths in 2015 and beyond. Based on a 25-year career in NHS analysis and demand forecasting may I point out that these recurring periods of higher deaths and medical admissions are always accompanied by higher delayed discharges. Observations such as the association between delayed discharges and deaths/medical admissions have, unfortunately, never been published, however, the curious association between increased deaths and medical admissions has been published. Rather than cite over 100 studies the reader is advised to go to a list of publications at where multiple aspects of cause and effect and possible causes have been explored.

    Time lags are evident, with unexplained increased deaths always lagging unexplained increased emergency admissions, and lags between males and females evident in very small area geographies. Admissions for particular diagnoses rise while others fall during these curious events. Casemix severity may well be affected.

    While it is clear that austerity has only exacerbated the impact of the current event on delayed discharges, as noted by the authors, I would be reluctant to say which trends are cause and effect, and which trends arise from association rather than causation.

    The clear message is that far more research is required by both...

    Show More
    Conflict of Interest:
    None declared.