On 13 January the BBC reported the contents of an internal email to doctors from the medical director and chief nursing officer at the Royal Cornwall Hospital.1 In response to “significant pressure,” and to free up bed capacity, the email urged doctors to discharge patients “earlier than some clinicians would like.” Last month the Guardian had carried a similar story from Norfolk and Norwich University Hospital, reporting internal memos urging senior doctors to find the “least unsafe option” in identifying patients to discharge.2 No doubt, senior operational and clinician managers at those trusts face an almost impossible balancing act. I’m sure that you’d find similar emails in dozens of acute hospitals around the NHS, given that they start each day in negative bed equity, with patients queuing in the emergency department, sometimes on trolleys in corridors. What struck me about both cases was that the …

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戴维·奥利弗（David Oliver）：提早出院对医生不利的风险。

1月13日，英国广播公司向皇家康沃尔医院的医疗总监和首席护理官报告了一封内部电子邮件的内容。1为了应对“巨大压力”并释放床位，该电子邮件敦促医生出院。患者“比某些临床医生希望的早”。上个月，《卫报》在诺福克大学和诺里奇大学医院发表了类似的故事，报道了内部备忘录，敦促高级医生寻找“最不安全的选择”来确定要出院的患者。2毫无疑问，这些信托基金的高级业务和临床经理面临着几乎不可能的平衡行为。我确信您会在NHS周围的数十家急诊医院中找到类似的电子邮件，因为它们每天都是从负床位开始的，患者在急诊室排队，有时在走廊的手推车上。令我震惊的是……