Older people's experiences of hospital care, discharge and getting home

Healthwatch Redbridge engaged with older residents to understand their experiences of local hospital care, hospital discharge, and post hospital support. This work was undertaken to assess how effectively the hospital to home pathway functions for an increasingly complex older population, and to identify where coordination between health and social care services is working well or breaking down. 

Feedback indicates that, while individual services deliver diligent care in places, the overall pathway is often inconsistent and fragmented. Older people described difficulties navigating their care, limited communication, variable personal care, long and unpredictable discharge waits, and mixed access to community-based support. 

A dedicated focus group with blind, visually impaired, and deaf residents highlighted additional barriers linked to disability awareness, accessibility, and staff understanding of sensory needs. 

These issues point to systemwide pressures rather than isolated service failures. The cumulative impact is a pathway that does not always provide older residents with the clarity, continuity, or safety they need as they move between hospital, community, and social care services. 

Key Findings 

Basic care was unreliable, with 44% reporting poor support with washing, dressing, and toileting, and half rating access to clean clothing and gowns as average or below. 

Noise levels were a major concern, with 60% describing the ward environment as poor or very poor. 

Patient safety processes showed weaknesses, including poor medication management (36% poor/very poor) and difficulty accessing call bells (32%).

 Communication and involvement were major concerns, with many patients reporting unclear explanations, not feeling listened to, and lacking confidence to ask questions. 

Access to therapy and community services was mixed, with district nursing and reablement rated positively, but physiotherapy, occupational therapy, mental health support, and care packages showing variable or negative experiences. 

Discharge processes were delayed and unpredictable, with most patients waiting 4– 12+ hours on the day of discharge. Medication and paperwork were the main causes of delay, and early discharge planning was inconsistent. 

Post hospital discharge support varied, with strong feedback for carers and district nursing but inconsistent experiences with therapy follow-up and equipment provision. 

Sensory impaired patients faced significant accessibility and dignity issues, including insensitive staff interactions, lack of awareness of visual/hearing needs, and practical barriers such as missed meals and poor navigation support.