Guiding you home

Healthwatch Sunderland undertook a survey to inform a new strategy to speed up hospital discharge. 31 people responded.

The findings show that respondents strongly value clear communication and coordinated discharge planning. Families want timely updates about a patient’s condition, early involvement in planning, and detailed information before discharge so they can prepare effectively. 

Respondents emphasised the importance of practical support being in place before discharge, including care packages, access to physiotherapy, ready prescriptions, and knowledgeable professional carers. They also highlighted the need for home preparation, such as safety checks and provision of mobility aids, to ensure patients can return home safely. 

Ongoing aftercare and follow-up support were also seen as essential, with suggestions including helplines, home visits, and regular check-ins to monitor recovery. Overall, respondents want a discharge process that is well-organised, person-centred, and safe. 

Views on whether care homes provide better care were mixed. While just over half believed home was preferable, many stressed that this depends on whether adequate support is available. Some respondents felt care homes may be more appropriate for individuals with complex needs, such as dementia, highlighting the importance of tailoring decisions to individual circumstances. 

Carers reported needing reassurance and support for themselves, including a single point of contact, accessible information, involvement in planning, and guarantees that care arrangements are in place before discharge. They also highlighted the need for employer flexibility and time off work to manage caring responsibilities during the transition period. 

Additional feedback revealed that poor communication and lack of coordination can leave families feeling overwhelmed and unsupported. Many described difficulties navigating services and securing appropriate care, particularly when discharge planning is unclear or rushed. 

The report identifies several key areas for improvement, including:

• improving communication between professionals, patients, and families;
• ensuring clear, fully coordinated discharge plans;
• arranging home care and support services before discharge;
• providing information packs with key contacts;
• establishing a 24/7 helpline; and
• offering guidance and support for unpaid carers, including employment rights. 

The provider response acknowledges the findings, agrees with the recommendations, and commits to improving communication and starting discharge planning earlier in a patient’s hospital stay.