Enter and view: Hospital discharge, Queen Elizabeth Hospital

Hospital discharge was raised as a priority for Healthwatch Greenwich especially after two subsequent CQC reports rating the service at Queen Elizabeth Hospital, first as ‘inadequate’ and the second time as ‘requires improvement’.

Due to the lack of beds at the hospital the safe and efficient discharge of patients was essential for the smooth running of the hospital. At that time, it was running at 50% delayed discharge.

To consider the issues around hospital discharge in QEH, HW did a focus group discussion on February 16th which aimed to bring patients, carers, residents, and professionals together to discuss their experiences of hospital discharge. It also scheduled enter and view visits to the discharge lounge at QEH to talk with and gather feedback from patients who are preparing for discharge.

In the focus group, round table discussions were set up to hear personal experiences and ideas about best practice. The discussion looked at discharge considering homelessness, communication, continuity of care, beds available, medication and finding alternatives to A&E.

The HWG team then conduced four scheduled E&V visits to the discharge lounge at QEH to gather feedback from patients who were scheduled for discharge. They reviewed the discharge service in light of environment and cleanliness, treatment by healthcare staff, readmission, bed usage and delays, communication throughout admission, information about the discharge process and support services available, involvement in the decision making around leaving hospital, housing and family/community support after discharge and medication.

HW team made a few recommendations

Consideration should be given to the patient’s own feelings about whether they consider themselves ready for discharge.

The hospital should produce a discharge checklist, which lists all services that the patient could be referred to with contact details and how to access them.

Clear information about the discharge process should be given to all patients when they are first admitted. Where additional needs are identified, these should be assessed for and put in place well before discharge.

The discharge lounge should not be used as an overflow for other wards in the hospital.

Lewisham and Greenwich NHS Trust, Greenwich CCG and RBG must work together to jointly commission and fund an increase in suitable short and long-term beds to ensure that patients can get the care they need outside of the hospital setting in a timely manner. They should also commission a ‘task force’ to go into services recently rated inadequate and tackle the identified issues, with a view to returning the embargoed beds into full use.

Patients being discharged, who have been prescribed medication by the hospital, must be fully informed of how and when to take the medication.

The service providers response and actions to be taken are included in the report.