Improving the discharge process

October 5, 2017

A new briefing What happens when people leave hospital and other care settings? outlines where important steps have been made towards improving the discharge process for patients.

However, the 2,083 people’s stories used to compile the findings also continue to show significant variation. This highlights the need for good practice to be spread and properly evaluated to ensure it is having the right impact.

In 2015, Healthwatch England’s Safely Home inquiry helped to galvanize systemwide leadership to tackle the underlying problems of transferring patients between services. Yet it is clear from NHS statistics, such as the numbers of delayed transfers of care hitting record levels last winter, that the challenge is still growing.

This new briefing looks at what 46 local Healthwatch heard about people’s experiences of the discharge process since 2015.

Key findings include:

  • People still don’t feel involved in decisions or that they have been given the information they need, including advice on possible side effects of new medications or who to call for advice out of hours.
  • People continue to experience delays and a lack of co-ordination between services, highlighting specific problems with hospital pharmacy services, patient transport, and care homes or family members not being notified when people are about to be discharged.
  • People feel left without the services and support they need after leaving hospital, with discharge plans not considering patients’ other clinical needs or home environment, including whether or not patients have carer responsibilities.

Healthwatch is calling for a fuller understanding of what’s happening in local areas, with local leaders urged to use the experiences of the people behind the delayed transfers of care statistics to identify where improvements can be made.

The new Healthwatch briefing highlights a number of approaches that are already helping to reduce delays getting people out of hospital, such as Discharge to Assess and Red2Green. However, wherever they are introduced, new programmes must be evaluated to ensure they are having the right impact, and that people are getting home safely and efficiently.

Imelda Redmond, National Director of Healthwatch England, said, 'Getting people out of hospital and safely home is not about a single point in time. It is an ongoing process that requires thought, planning and support before, during and after the moment someone is actually discharged. Things work best when staff in all services work together to provide a seamless experience.

'Whilst we heard plenty of positive stories from people moving between hospitals, care homes and their own homes, the number of people stuck in hospital waiting to leave has increased significantly. From what people tell us, it is clear many of the common problems around communication and coordination are still ongoing.

'Healthwatch will continue to play our part, working with hospitals, community services and the public to improve people’s experiences.'

For care providers wanting to know more about how to assist people in the move from hospital to home or a care home, the Social Care Institute for Excellence and the National Institute for Health and Care Excellence has published a quick guide for registered managers.


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