Patient experiences of hospital discharge pathways 1 - 3 in Newcastle Hospitals

This is a report by Healthwatch Newcastle. The project looks at experiences of hospital discharge.

Collecting reflective feedback from patients with significant care needs after discharge from hospital remains a persistent challenge, leading to gaps in understanding the effectiveness of the hospital discharge pathway. 

To address this issue, this research project focused on developing a survey to gather feedback from patients, particularly those discharged on pathways 1-3 from Newcastle upon Tyne Hospitals NHS Foundation Trust (NuTH).

There are recommendations in this report:

• 82% of patients unaware of which discharge pathway they were on. NuTH hospital discharge staff team should provide patients with a simple, verbal and written explanation of their specific discharge route upon admission, or as soon as it is known, therefore bettering their communication with patients.
• Only 39% of respondents felt involved in decisions. The hospital discharge staff team should be trained and encouraged to engage patients early in the discharge planning process, ensuring their input and understanding are prioritised. This will enhance patient involvement in decision-making.
• There is a need to improve discharge lounge awareness and functionality. Since 67% of RVI patients did not know they were in the discharge lounge, hospital discharge staff team should give a short briefing or explanation when moving patients to the lounge, to introduce patients to the lounge purposefully.
• To strengthen aftercare and follow-on support, the hospital discharge staff team should work closely with others who need to be in the planning loop for care plans (e.g. family/carer, social care, community services etc.), to ensure every patient has a follow-on care plan before leaving hospital, given that 64% of patients reported not receiving one.
• Hospital discharge staff team should introduce mandatory structured post-discharge check-in calls or texts within 48–72 hours to answer any questions, offer reassurance, and identify issues early. This can besent as a ‘task’ to hospital discharge staff team, via the patient system used.
• Additionally, there should be a named ‘discharge co-ordinator’ for each patient, who knows and understands the plan, and for the patient/carer to call in extremis.
• Hospital discharge staff should manage medication prescriptions in advance to avoid long waits for doctor signoffs, potentially by having doctors review medications the day before or exploring alternatives, such as other qualified/authorised staff or pharmacists, to handle this task.
• The patient experiences shared in this report shows the need to improve communication and coordination as they go through the hospital discharge process. Also, a more compassionate approach would be welcomed from staff to the patients and including their caregivers/family more in the process. Healthwatch Newcastle needs to act upon this feedback, by creating a working group to review the findings of this report. This working group could include representatives from the hospital, the system flow coordination, VCSE and adult social care. The aim of this working group would be to coproduce service change to improve the hospital discharge experience for patients.

There are not follow up actions in this report. The providers have responded.