Hospital Discharge Report

Healthwatch Hartlepool undertook research into hospital discharge to follow up their 2014 report on the topic.  They undertook a survey and attended community engagement events.  Altogether they collected 40 responses.

There had been some change in many aspects of the discharge process since our previous investigation in 2014. Most noticeable of these is the progress that has been made in developing integrated working practices which have resulted in a much-improved collaboration between health and social care stakeholders in the discharge pathway.

However, the research also shows that there are still challenges to overcome. A significant number of patients do not feel involved in the planning of their discharge and in some cases, arrangements have not been fully discussed until they are about to leave hospital. Some patients were given little information about their forthcoming discharge and subsequent care arrangements, whereas others have said that they and their families were fully involved in planning their discharges from the early stages of their admission.

Communication is the key to a successful discharge, ongoing patient recouperation and minimising the chance of re-admissions.

Some patients reported delays in changes to care packages being implemented post discharge and long waits for equipment and adaptations. A particular area of concern are the long waits which some reported for OT assessments, again leading to delays in the introduction of much needed adaptations and equipment.

Communication issues are also highlighted by care homes and domiciliary care providers. Information is often reported to be limited around patient discharge processes and arrangements. In order for care homes to be ready and prepared to receive residents back to their home adequate notice is needed to ensure paperwork is completed and changes to medication and care packages are implemented immediately and safely. The homes also expressed concerns that there had been occasions on which they were worried about the fitness of a resident to be discharged back to the home, again emphasising the need for good communication in the run up to discharge.

Finally, some homes raised concerns about lack of clarity around medication changes in discharge letters and DNAR’s not being returned with the resident, again highlighting the need for improved communication.

Many patients who attended the Discharge Hub, reported long waits for medication and transport. Timely availability of medication still appears to be a significant cause of extended stays in the Discharge Hub, and on one of our visits we observed the nurse on duty having to go to pharmacy to collect a patient’s medicines.

The report contains 12 recommendations about communication and involvement, information, access to support, accessibility, transport, medication and location of services.