Healthwatch: NHS urged to do more to help patients leave hospital safely (20 November 2023)

Summary

New research from Healthwatch reveals worrying problems with hospital discharge arrangements. Many people told us they are not given the right support or information when being discharged from hospital. Read on about their experiences and Health Watch's calls to action.

Content

Key findings 

• Over half, 59%, of people said the hospital discharge team didn't ask if they needed support in getting transport to the place they were discharged to, contrary to government guidance  
• People discharged either in the early hours, before 9 am, or late, after 6 pm, were significantly less likely to be asked if they needed transport. 
• Over half, 51%, of people weren’t given contact information for further help or advice when leaving the hospital, contrary to government guidance
• Nearly a third, 32%, felt unprepared at discharge. 
• Carers were more likely than patients to say they didn't feel prepared at discharge (44% of carers, 25% of patients).
• Over one in ten, 11%, had to wait over 12 hours after being told they were well enough to leave the hospital.
• Over one in five, 24% reported an excellent hospital discharge experience, with 37% reporting either a mixed or neutral. 

Healthwatch are calling for:

• The Government to update its hospital discharge and community support guidance. It must include new minimum standards on transport waiting times and post-discharge contact times.
• Integrated Care Boards (ICBs) to be consistent in implementing the latest hospital discharge guidance, including: 
• Supporting people to make informed choices by providing contact information and advice and asking about transport home;
• Better signposting to support services, including voluntary organisations and services that support unpaid carers; 
• Dedicated staff who will make travel arrangements; 
• Points of contact for people to use if their condition gets worse;
• Greater involvement of family and carers in decisions about people discharge.
• Urgent government reform of the social care system to ensure councils and providers have the staff, skills, and resources to support people to live independently, including reablement support at home or in residential care following discharge from the hospital. 
• ICBs to focus on workforce solutions in secondary care, including a review of staff retention policies and the development of plans to increase the capacity of administrative staff in local NHS trusts. Admin staff should act as points of contact for those coming into and leaving the hospital and support the work of 'transfer of care' hubs
• NHS Digital to capture and report data on deterioration in health at seven and 30 days after discharge, to understand where discharge processes are not always working for patients. This includes collecting data on emergency readmissions, death after discharge, and contact with another health service about the same condition.