The following project was led by Healthwatch Windsor, Ascot and Maidenhead in close collaboration with Healthwatch Buckinghamshire, Slough, Wokingham, Bracknell Forest, Hampshire and Surrey.
NHS Choices1 states that once a patient is admitted to hospital, their care plan (including information about their discharge) is developed. During a patient's stay in hospital, a discharge assessment is undertaken to determine if a patient needs more care after they leave the hospital.
Every patient should be fully involved in the discharge assessment and, where a patient consents, family or carers should also have the opportunity to contribute to this. However, it is suggested that a patient should not be discharged from hospital until:
- They are medically fit (this is decided by the consultant or someone the consultant has said can make the decision on their behalf).
- They have had an assessment to look at the support the patient may need to be discharged safely.
- They have been given a written care plan that sets out the support the patient will get to meet their needs.
- The support described in the patient's care plan has been put in place and it is safe for the patient to be discharged.
There are many factors that can lead to a patient experiencing a delay in being discharged from hospital. In the year 2015/16, the most common reason for a patient experiencing a delay in being discharged from hospital in England was having to await further non-acute NHS care (e.g. community support, mental health care, intermediate care or rehabilitation services).
Recommendations from the report
The following areas of good practice have been identified from the information collected through the discharge survey:
- The majority of respondents reported that they felt that they were treated with dignity and respect during their stay in hospital.
- Many respondents from various hospitals reported that hospital staff were caring, kind and supportive. Respondents frequently identified that nursing staff had positively contributed to their stay in hospital.
- 82% of patients at Frimley Park Hospital reported that the time of their discharge was satisfactory and in accordance with their wishes. Frimley Park Hospital to consider sharing best practice in this matter with other hospitals in the Frimley Health NHS Foundation Trust and with Healthwatch WAM.
Based on the key findings the following recommendations have been made:
- Hospitals should consider reviewing their methods of record keeping to prevent patients from having to repeat their medical history to hospital staff.
- Hospitals should consider reviewing the way in which they are providing medicine to patients upon discharge, with the aim of discharging patients in a more timely fashion.
- Hospital staff should discuss with all patients, as appropriate, the need for health and social care services after leaving hospital.
- Hospital staff should communicate to all patients their care plan, including any services that they may expect to receive and any services that may not be provided, and ensure that this information has been understood.
Discharge Report June 2017