"Let's get you home"

Healthwatch Brighton and Hove carried out a review of hospital discharge arrangements for older people discharged from the Royal Sussex County Hospital between July and September 2018. The project involved interviews with 80 patients in hospital, followed by interviews with 49 patients after they had returned home. While most patients praised the quality of care received in hospital, the review identified significant concerns about discharge planning, communication and the coordination of support after leaving hospital.

A major finding was that many patients did not feel adequately involved in decisions about their discharge. Nearly 60% felt they were not involved, or only partly involved, in decisions about their care, and many reported receiving little or no written information about what would happen after leaving hospital. Almost half said nobody had discussed what would happen when they returned home, and many felt they were not fully prepared for independent living after discharge.

Experiences after discharge were mixed. Although most patients were satisfied overall with discharge arrangements, many reported gaps in support, poor communication and difficulties accessing services that had been discussed before discharge. Some patients did not know who to contact if problems arose, while others experienced delays to physiotherapy, speech therapy, home adaptations or community-based support. Family members and friends often played a crucial role in helping patients manage after discharge and compensate for shortcomings in formal arrangements. 

Healthwatch concluded that stronger discharge planning, better communication and more personalised care were needed. Recommendations included starting discharge planning within 24 hours of admission, providing all patients with clear written and verbal discharge information, involving patients and family members in decisions, improving communication between hospital and community services, reducing delayed discharges, providing better support for independent living, and ensuring all patients know what support is available and who to contact once they return home. The local Clinical Commissioning Group welcomed the findings and committed to implementing improvements in discharge information, patient involvement and follow-up arrangements.