Supported transfer to care from hospitals

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Summary of report content

Healthwatch Somerset wanted to understand the transfer of care process to use the experiences of people who have been discharged from hospital to inform the organisations involved to support change and improve the process. They analysed their public feedback, gathered new stories and spoke to people in care homes.  They spoke to 27 people.

They identified the following key messages:

  • There is a lack of communication and information from hospital staff to patients and their family or carers about the transfer of care process and the support available to them.
  • There are also gaps in communication from hospital staff regarding diagnosis and treatment
  • Patients, families, and carers are often notified of their discharge from hospital on the same day, sometimes with only a few hours for them and their family or friends to prepare.
  • Transporting patients home can be problematic due to a lack of community transport or support moving patients to and from personal transport.
  • Some patients felt they had been discharged from hospital too early.
  • Some patients did not feel listened to by hospital staff.
  • There is confusion surrounding the need for, and provision of, essential clinical items such as dressings, and also community equipment required during recovery.
  • There is a lack of continuity of care between the health and social care services

The report contains four recommendations about better communications between staff involved in a discharge, between staff, patients and family/carers, transport home and continuity of care.

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General details

Local Healthwatch
Healthwatch Somerset
Publication date
Key themes
Caring, kindness, respect and dignity
Communication with patients; treatment explanation; verbal advice
Consent, choice, user involvement and being listened to
Follow-on treatment and continuity of care
Discharge
Integration of services and communication between professionals
Service organisation, delivery, change and closure

Methodology and approach

Was the work undertaken in partnership with another organisation?
No
Primary research method used
General feedback
Interviews
If an Enter and View methodology was applied, was the visit announced or unannounced?
N/A

Details of health and care services included in the report

Details of health and care services included in the report
Care home
Discharge lounge/ discharge team/ discharge to assess
District nurse and community nursing
Equipment services (including wheelchairs, incontinence, home adaptations)
Inpatient care/General inpatients

Details of people who shared their views

Number of people who shared their views
27
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