Rapid responses are electronic comments to the editor. They enable our users
to debate issues raised in articles published on bmj.com. A rapid response
is first posted online. If you need the URL (web address) of an individual
response, simply click on the response headline and copy the URL from the
browser window. A proportion of responses will, after editing, be published
online and in the print journal as letters, which are indexed in PubMed.
Rapid responses are not indexed in PubMed and they are not journal articles.
The BMJ reserves the right to remove responses which are being
wilfully misrepresented as published articles or when it is brought to our
attention that a response spreads misinformation.
From March 2022, the word limit for rapid responses will be 600 words not
including references and author details. We will no longer post responses
that exceed this limit.
The word limit for letters selected from posted responses remains 300 words.
I have only read the abstract of this article on admissions from
nursing homes for people who are dying but as a GP several answers as to
why people in nursing homes are sent to hospital can be answered. Firsty
out of hours care in now triaged with protocols by call handlers who may
have neither nursing or medical qualifications. This is often in response
from the NH that is worried that any death may lead to an investigation by
their monitoring organisation and censure if they were deemed not to have
acted appropriately. These organisations sometimes appear to expect people
in N.H. not to decline and if they do want actions taken to reverse that
decline even if there seems no prospect of that. So yes advance planning
will help but 'out of hours' fear of blame leads to automated hospital
admission or does in some circumstances
Audit of admission times and who arranged admissions might help
I have only read the abstract of this article on admissions from
nursing homes for people who are dying but as a GP several answers as to
why people in nursing homes are sent to hospital can be answered. Firsty
out of hours care in now triaged with protocols by call handlers who may
have neither nursing or medical qualifications. This is often in response
from the NH that is worried that any death may lead to an investigation by
their monitoring organisation and censure if they were deemed not to have
acted appropriately. These organisations sometimes appear to expect people
in N.H. not to decline and if they do want actions taken to reverse that
decline even if there seems no prospect of that. So yes advance planning
will help but 'out of hours' fear of blame leads to automated hospital
admission or does in some circumstances
Competing interests:
None declared
Competing interests: No competing interests