A joint report by Healthwatch Warrington and Healthwatch Halton has called for improvements when patients are discharged from hospital.
The report was based on the feedback from 90 patients and their carers/family members who had been inpatients at Warrington & Halton Teaching Hospitals NHS Foundation Trust.
Where discharge had worked well, people highlighted good communication, feeling involved in the process, involvement of their family members where applicable, and good coordination and quality of aftercare. Too often, though, there were inconsistencies in the discharge experience of the patients who were spoken to.
The report revealed:
• Patients and their carers said they were not given the right information or ongoing support when being discharged from hospital.
• 27% of patients said they were dissatisfied with how they’d been involved in conversations about their discharge.
• 43% of carers said they were unhappy with the discharge and follow-up care of their loved ones.
• Many carers and family members said they didn’t feel prepared for their loved one’s discharge.
• Carers were more likely than patients to say they were dissatisfied with the discharge process and care received following discharge (43% of carers, 25% of patients).
• Almost half of patients, 48%, said they weren’t asked if they needed support in getting transport to the place they were discharged to, contrary to government guidance.
• Not all patients were aware if they had a care plan or not. If they had a care plan, they were often unaware of what was included.
Lydia Hughes CEO for Healthwatch Warrington said: “The discharge process involves a number of partners and services for it to go well. Improvements need to be made Warrington wide, and not just for the Hospital to take sole responsibility to create an action plan. Both Health and Social care can work together to achieve better outcomes for patients’
Although this is a national issue, there are still improvements we can make locally.”
Dave Wilson, Chief Executive Officer at Healthwatch Halton added: “Hospital stays are frequently a time of stress and uncertainty for patients, and waiting for discharge can heighten this. It’s important for the welfare of patients, their families, and carers, that the whole discharge process is as smooth and seamless as possible.
“The stories we heard highlight the current inconsistencies in the system. While we recognise that a ‘good discharge’ for patients will not necessarily always be one in which everything goes to plan, the negative impact of any delays or disruption can, in some cases, be mitigated by ensuring the patient, carer or families are kept fully informed and involved at all stages of the process.’
One story shared with Healthwatch Halton stated: ‘At 1.30 in the morning my wife was discharged and told she could go home. There was no patient transport, and we couldn’t get a taxi… It was a total stranger who overheard our conversations who was at the hospital who volunteered to give us a lift home.’
Another shared with Healthwatch Warrington said: ‘Carers were meant to be at home, but no one was there when I arrived home. Friends had to arrange food, this was not checked at discharge. Medication given just with leaflets in box. I had a discussion with GP and pharmacist myself when home.’
Healthwatch has called for:
• Patients and families need to be involved in conversations about their care and to be informed as early as possible in the process about what the possibilities are.
• All patients to be involved in the formulation of their care plan, and staff should discuss with patients and family members what is included.
• Improve involvement of people in conversations about their discharge at all stages of their hospital journey.Better communication:
Routinely ask people receiving hospital treatment or care and their family members whether they have any communication needs and act on these in line with duties outlined in the Accessible Information Standard.
There needs to be a consistent approach to conversations around any support needed upon discharge.
In response to the findings Dan Moore, Chief Operating Officer and Deputy Chief Executive at Warrington and Halton Teaching Hospitals NHS Foundation Trust said: “We know it’s much better for our patients’ physical and mental wellbeing to leave hospital as soon as they are medically ready to do so. As a Trust we always aim to support our patients with a smooth discharge to continue their recovery at home.
“We welcome the insight provided by this report and it is positive to see that 73% of patients felt prepared for their discharge. However, we know there is more that can be done, particularly around discharge conversations and communication with carers, which is highlighted in this report.
“The Trust remains committed to supporting improvements to ensure our patients, carers and families have a positive experience. We will continue to work with our partners in the wider Cheshire and Merseyside system to develop a joined-up action plan to improve discharge processes and achieve better outcomes for patients.”
The full report can be found on Healthwatch Warrington’s Website here:
https://www.healthwatchwarrington.co.uk/report/2024-07-15/hospital-discharge-report-2024
