Healthwatch finds dreadful discharge

Emdad Rahman

Thousands of people are potentially being sent home without proper support when they leave hospital or a care home. Some of them are left isolated and end up in a predicament that could have been averted.

An enquiry by Healthwatch UK has focussed on homeless people with mental health conditions and older people who have been sent home from hospitals, care homes and mental health units. The enquiry found that vulnerable adults are unaware of the extent of their health problems as they are discharged too early or provided sufficient information beforehand.

Healthwatch launched the enquiry in order to shine a light on how badly things can go wrong after vulnerable people – including rough sleepers – are discharged from health and social care institutions. The “People’s Inquiry” lifted the lid on the dangers of discharging tens of thousands of mental health patients and homeless or elderly people, who are often left without any support.

Concerns were raised about the way that homeless people are discharged from hospital. In 2015 Healthwatch set up a GP practice comparison website which includes information on how long it takes to get an appointment. Following this initiative, a further 14 other local Healthwatch branches have set up “Feedback Centres” on their websites, covering all health and social care services. This now enables patients to provide effective feedback using a star rating.

At Royal Stoke University Hospital, patients have fed back to say that access to doctors and nurses has been difficult, while 25% of survey participants stated that they have felt that they had had no chance to air concerns and no involvement in discharge matters. Others said that professional help was lacking. These findings came as a result of 133 discharged patients completing and submitting a survey at Royal Stoke’s frail elderly assessment unit. Hospital staff are also encouraged to have health advocates available to talk and advise patients who are finding it difficult to engage with staff at hospitals.

The research was lead on by Healthwatch Stoke-on-Trent and the findings will now be used to help leaders of the programme – called “Step up, Step down” – to make effective and informed final decisions related to patient discharge. Healthwatch manager Val Lewis said: “We found a significant proportion of frail and elderly people might not understand what is happening to them on the ward and that this continues through discharge and onto the next part of their journey.”

Paul Astley, Group Information Officer, who led the project, added: “It suggests more work could be done to understand their needs in enabling them to become the active participants they need to be to improve their outcomes.”

Royal Stoke chief nurse Liz Rix said: “There are always areas we are looking to improve and we will use this report to highlight where we can make amendments to patient care. These are some of the most vulnerable patients and this report shows we are providing a high quality standard of care for them.”

Of those returning forms, 21.3% said they did not know what was happening to them while in hospital, 29.3% found it hard to talk to doctors and nurses and 25.7% felt they could not share concerns about their discharge. Healthwatch continues to make enquiries and the organisation’s investigations are being led by people with direct experience of unsafe discharge.

Healthwatch is gathering all of these different experiences to find out where there are problems in the system and to highlight things that are already working well. It will use this evidence to advise the Secretary of State for Health and organisations responsible for health and social care like NHS England and local authorities about changes they think are needed to be made to improve people’s experiences.

•If you have any questions at all about the inquiry then please do get in contact with the Special Inquiry team: specialinquiry@healthwatch.co.uk 020-7972 5002