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Hospitals discharge processes putting patients at risk, Healthwatch England finds

Half of hospitals discharging patients without checking they have sufficient food and heating at home

Ingrid Torjesen

Tuesday, 21 July 2015

Hospitals are discharging vulnerable patients without ensuring they have adequate support at home and as a result many are readmitted, an investigation by Healthwatch England has found.

Its new report launched today - 'Safely Home: What happens when people leave hospitals and care settings?' - brings together 3,230 stories and pieces of evidence, gathered by 101 local Healthwatch from across the country, revealing both the human and financial cost of getting the discharge process wrong.

Many of the problems stem from organisations failing to think beyond their own direct responsibilities with discharge plans often not considering patients' other clinical needs or home environment, including whether or not patients themselves have carer responsibilities.

The report identifies a number of common basic failings including more than half of trusts are not recording whether patients have a home or safe place to be discharged to, including things like whether there is any food at home or if the heating works; one in ten are not making sure that a friend, relative or carer is notified when the patient is discharged, and one in three are not ensuring notes about new medications are properly recorded and passed to GPs or carers.

The investigation centred on three vulnerable groups of patients – the elderly, homeless and people with mental health conditions. Patients reported that they were often not included in care decisions or given the information they needed and some felt stigmatised.

And poor discharge planning is costly for the NHS. In 2014, the NAO reported that in the space of a year the NHS deals with one million emergency readmissions within 30 days of discharge, costing an estimated £2.4 billion. A survey for Healthwatch England found 17 per cent patients readmitted for the same issue within three years returned to hospital within just seven days, suggesting a significant problem with current processes.

Anna Bradley, Chair of Healthwatch England, said: "Throughout the inquiry we have heard thousands of shocking stories about what happens when people leave hospital without the right planning and support. This is not a new problem, but what makes these findings worse, is that in many cases some pretty basic things could have made all the difference.

"There is a huge human and financial cost of getting discharge wrong. We hope that the increased focus on integration of health and social care, and pressure on finances will create a new impetus to fix it.”

Phil McCarvill, deputy policy director of the NHS Confederation, said: “The scale and complexity of the NHS can sometimes make the experience of care feel less tailored to individual’s needs. Delivering compassionate, dignified care must be the top priority of everyone who works in the NHS and change is needed wherever patients’ experience falls below that standard. There’s no one-size-fits-all solution so we need local leaders to continue working with key partners, such local authorities and the voluntary sector, to shape services and ensure the delivery of care in the right way, the right place and at the right time.

“The NHS Confederation will work closely with Healthwatch and other partners to develop this agenda.”

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