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Found 167 results
  1. Content Article
    The Re-Engineered Discharge (Project RED) programme is a nationally recognised best practice centered on delivering a patient-tailored hospital discharge plan demonstrated to reduce all-cause 30-day readmissions and improve safety during care transitions. In this study, Mitchell et al. implemented the RED in 10 hospitals to study the implementation process.
  2. Content Article
    As the pandemic approached England in early 2020, government policy decisions ensured most people stayed at home and NHS hospitals were largely protected. Yet some lives were not saved that should have been and England subsequently experienced the highest levels of excess mortality in Europe. Now as we head towards a winter living with COVID-19, a new hospital discharge policy suggests the English NHS has not learned from early mistakes and may be putting the lives of vulnerable people at risk.
  3. News Article
    Serious patient safety and wellbeing concerns about the latest hospital discharge guidance have been raised to HSJ by senior clinicians and charities. Senior geriatricians warned that the guidance could prompt an increase in “urgent readmissions”, “permanent disability” and “excess mortality”, while charities said families could be left with “unsustainable caring responsibilities” because of the new rules. The government guidance, Hospital Discharge Service: policy and operating model, published in August, said clinicians should consider discharging patients when they were “medically optimised” rather than “medically fit”. It said 95% of these patients would return straight home with additional social care and rehabilitation support if needed. Many of the concerns raised surround the retention of the “criteria to reside”. This was originally agreed in March when there was a push from NHS England to free up acute beds over fears hospitals would become overwhelmed with covid admissions as the pandemic hit the UK. The criteria has, however, been maintained in the new guidance, despite a significant fall in infections and deaths from the virus. Rachel Power, chief executive of The Patients Association charity, warned: “This guidance makes it clear that the NHS is still having to take drastic emergency action in the face of covid-19, that will continue to take a heavy toll on patients. It is clear that many patients will be rushed home who would normally have had a longer period of hospital care.” Read full story (paywalled) Source: HSJ, 8 September 2020
  4. Content Article
    This document from the Department of Health and Social Care (DHSC) sets out how health and care systems can ensure that people: are discharged safely from hospital to the most appropriate place. continue to receive the care and support they need after they leave hospital. It replaces ‘Coronavirus (COVID-19) hospital discharge service requirements’ published on 19 March 2020.
  5. Content Article
    In 2019 The King's Fund discussed the following eight key problems facing social care and called for reforms to address them: means testing: social care is not free at point of use like the NHS catastrophic costs: some people end up paying large amounts and even selling their homes to pay for care unmet need: many people go without the care and support they need quality of care: a wide spectrum of concerns, from 15-minute care visits to neglect and lack of choice and control workforce pay and conditions: staff are underpaid, leading to high vacancy rates and turnover market fragility: care providers go out of business or hand back contracts disjointed care: health and care is not integrated around the individual and causes issues such as delayed transfers of care from hospital the ‘postcode lottery’: there is unwarranted variation between places in access to care and its quality. The pandemic has shone an uncompromising light on the social care sector. In this article, Simon Bottery explores how COVID-19 has exacerbated these pre-existing challenges.
  6. Content Article
    The Re-Engineered Discharge (RED) Toolkit helps re-design the discharge process using health literacy and patient safety strategies. Research showed that the RED was effective at reducing readmissions and post-hospital emergency department visits. The RED Toolkit includes templates for easy-to-understand discharge instructions and post-discharge telephone calls, and guidance on delivering the RED to diverse populations. This is part of AHRQ's health literacy improvement tools to help healthcare organisations, leaders and professionals improve health literacy.
  7. Content Article
    This is a report of a qualitative survey that explored unsafe, premature discharge from hospital. The Patients Association has regularly heard from helpline callers that patients believed that they had been discharged too early from hospital,and that as a result they had either suffered harm or been at risk of harm.
  8. News Article
    Problems with hospital discharges in England, highlighted in the largest annual patient survey, reinforce the need for greater integration between health and social care, the sector regulator has said. The Care Quality Commission inpatient survey found that a majority of patients were positive about their hospital care but a significant minority experienced problems on discharge. A third of respondents who were frail said the care and support they expected when they left hospital was not available when they needed it. Three in 10 frail people said they had not had discussions with staff about the need for further health and social care services they might require post-discharge. Four in 10 of all patients surveyed left hospital without printed or written information about what they should or should not do after discharge, and the same proportion said their discharge was delayed. Read full story Source: The Guardian, 2 July 2020
  9. Content Article
    The National Falls Prevention Coordination Group has identified resources to address Covid-19 related falls and fracture issues including advice for patients on keeping active following hospital discharge. The advice leaflet has been designed for patients who are discharged home with no community rehabilitation and can be download via the Chartered Society of Physiotherapy link below. It explains why muscle wasting occurs with prolonged bed rest or inactivity and why it is important to be active when discharged home from hospital. 
  10. News Article
    The government said it will set up ‘dedicated team’ to look for innovative ways for the NHS to continue treating people for coronavirus, while also providing care for non-covid health issues. In its pandemic recovery strategy published today, the government also said step-down and community care will be “bolstered” to support earlier discharge from acute hospitals. The 60-page document contained little new information about plans for NHS services, but said: “The government will seek innovative operating models for the UK’s health and care settings, to strengthen them for the long term and make them safer for patients and staff in a world where COVID-19 continues to be a risk. “For example, this might include using more telemedicine and remote monitoring to give patients hospital-level care from the comfort and safety of their own homes. Capacity in community care and step-down services will also be bolstered, to help ensure patients can be discharged from acute hospitals at the right time for them". To this end, the government will establish a dedicated team to see how the NHS and health infrastructure can be supported for the COVID-19 recovery process and thereafter. Read full story Source: 12 May 2020
  11. Content Article
    The Health and Social Care Select Committee is currently holding an Inquiry into Delivering Core NHS and Care Services during the Pandemic and Beyond. It’s stated aim is to ‘give focus to these upcoming strategic challenges, and give those working in the NHS and care sectors an opportunity to set out what help they will need from Government in meeting them’[1]. In its call for evidence the Inquiry has specifically identified ‘meeting the needs of rapidly discharged hospital patients with a higher level of complexity’ as one of the issues it will cover [2]. This is a joint submission (see attachment) to the Inquiry by Patient Safety Learning and CECOPS which is focused on this specific issue.
  12. Content Article
    This webpage from Age UK gives advice on how elderly people can get support after they have been discharged from hospital. Content includes: How will I be assessed for help? Will I have to pay for help at home? What are intermediate care and reablement services? How do I arrange my own homecare after hospital discharge?
  13. News Article
    The next few months will be full of grim updates about the spread of the new coronavirus, but they will also be full of homecomings. Patients hospitalised with severe COVID-19, some having spent weeks breathing with the help of a mechanical ventilator, will set about resuming their lives. Many will likely deal with lingering effects of the virus — and of the emergency treatments that allowed them to survive it. “The issue we’re all going to be faced with the most in the coming months is how we’re going to help these people recover,” says Lauren Ferrante, a pulmonary and critical care physician at the Yale School of Medicine. Hospital practices that keep patients as lucid and mobile as possible, even in the throes of their illness, could improve their long-term odds. But many intensive care unit doctors say the pandemic’s strain on hospitals and the infectious nature of the virus are making it hard to stick to some of those practices. Read full story Source: Science, 8 April 2020
  14. News Article
    A major new model of post-acute care is needed for the discharge and rehabilitation of patients following COVID-19 infection, say Alice Murray, Clare Gerada, and Jackie Morris. A comprehensive plan must be made for the 50% of COVID-19 patients who will require some form of ongoing care following admission to intensive care, with the goal of improving their long-term outcomes and freeing-up much-needed acute hospital capacity. While the current focus is quite rightly on emergent cases, planning should be set in place to create post-acute care resources and facilities for the surge in numbers of people with the physical, psychological and functional consequences of prolonged ITU stays and or hospital admission following COVID-19 infection. One potential solution is to provide mass facilities, on a scale to match the Nightingale Hospitals in so-called “Centres of Excellence”, requisitioned for those who survive but need care and cannot return to their own homes, with both residential and day care units available. Read full story Source: HSJ, 9 April 2020
  15. Content Article
    Interventions information related to the patient’s medication and hospital stay is provided to the community pharmacists on discharge from hospital, who undertake a two-part service involving medicines reconciliation and a medicine use review. To investigate the association of this discharge medicines review (DMR) service with hospital readmission, a data linking process was undertaken across six national databases. The objective of this research, published by BMJ Open, was to evaluate the association of the DMR community pharmacy service with hospital readmissions through linking National Health Service data sets.
  16. News Article
    A major NHS hospital is under such pressure that it has decided to discharge people early even though it admits that patients may be harmed and doctors think the policy is unwise. The Royal Cornwall Hospitals NHS trust has told staff to help it reduce the severe overcrowding it has been facing in recent weeks by discharging patients despite the risks involved. In a memo sent on 8 January, three trust bosses said the Royal Cornwall hospital in Truro, which is also known as Treliske hospital and has the county’s only A&E department, “has been under significant pressure for the last two weeks and it is vital that we are able to see and admit our acutely unwell patients through our emergency department and on to our wards”. The memo added: “One of these mitigations was to look at the level of risk that clinicians are taking when discharging patients from Treliske hospital either to home or to community services, recognising that this may be earlier than some clinicians would like and may cause a level of concern. “It was agreed, however, that this would be a proportionate risk that we as a health community were prepared to take on the understanding that there is a possibility that some of these patients will be readmitted or possibly come to harm.” Read full story Source: 14 January 2020
  17. Content Article
    People with mental health problems need good, joined up physical and mental health care, both in hospital and the community. Successful joined up care depends on GPs, community and acute mental health care teams and social care professionals all having access to timely information about a persons care and treatment. The Professional Records Standards Body (PRSB) has developed the mental health discharge summary standard to ensure that relevant information is shared, so professionals can provide continuity of care when an adult is discharged from mental health services. It includes information on patient history and social context, medications, the details of their hospital admission, as well as current and previous diagnoses. The mental health discharge summary will improve professional communication between the patient's secondary care providers to their GP. It is very important to recognise the different nature of mental illness to physical illness and disease including the different methods of treatments and imperative follow-up care after discharge. The language used in the headings and in the clinical descriptions has been modified, where necessary, to be more inclusive and sympathetic to the nature of mental illness and processes of care. This project supports the NHS Digital and NHS England interoperability work
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