Bosses at a Norwich hospital say they are confident that patients, and in particular elderly and vulnerable patients, are not being inappropriately discharged in the middle of the night after carrying out a review.

Last month it was revealed that the Norfolk and Norwich University Hospital discharged more than 4,700 patients between 11pm and 6am in 2011, which amounted to 5.6pc of all discharges.

However, those figures could include deaths, or patients who decide to discharge themselves against medical advice, and now the hospital's chief executive and a senior nurse have looked in detail at a month's worth of night-time discharges.

Reporting on their findings to the hospital's council of governors, chief executive Anna Dugdale said she feel reassured that vulnerable patients are not being inappropriately discharged in the middle of the night.

The review found there were 409 late discharges in December 2011, 60 of which were deaths, 273 were speciality exclusions such as obstetrics, maternity and children, 18 were under-18 discharges and two were hospital transfer exclusions.

Of the remaining 62 patients, 26 were over the age of 65 and a detailed review of every set of their patient notes was conducted. Five were discharged to nursing homes or community beds, 14 were discharged with relatives and seven were discharged alone, all of whom were happy to be discharged for various reasons such as getting home on Christmas Day, wanting to keep another medical appointment the next day, self-discharge and having their own transport home.

Ms Dugdale said: 'I was really quite upset to see we discharged so many elderly people apparently in the middle of the night, so we spent an afternoon going though all the patient notes.'

She added: 'We have analysed one month and what we got from that is that we are not discharging people in appropriately in the middle of the night.'

From April 1, 2011, to March 31, 2012, the hospital had four complaints around the issue, however in each case patients had returned home following assessment in the accident and emergency department and the hospital says therefore the complaint was not about discharge from the hospital, but rather the decision not to admit.

Sue Burt, a hospital governor and A&E sister, said: 'In A&E we do admit patients for social reasons. Elderly patients who come in at night time and live alone are sometimes admitted and that's been going on for years, but we are sensitive to it the issue of sending people home at night.'

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