“Shocking” lack of care for vulnerable people discharged unsafely from hospital has been condemned by the state-funded “consumer champion” Healthwatch England.
Common basic failings identified in its report included hospitals not routinely asking patients if they have a home or safe place to be discharged to, details of new medications not being passed on to GPs and carers, and the failure to notify families when relatives were discharged.
The report – Safely Home: what happens when people leave hospital and care settings? – covered the experience of more than 3,000 patients, either older, homeless or with mental health problems. These included the story of a man being discharged from care after a suicide attempt despite his pleas to stay, who killed himself a week later.
Other examples involved an 81-year-old man who had suffered a third severe stroke being discharged from hospital via taxi at 10.30pm without his family being notified, and a young mother being kept in hospital, away from her daughter, because health and social services could not agree on the funding of her care.
Healthwatch’s concerns were first revealed by the Guardian in January. Anna Bradley, the organisation’s chair, said on Monday that it had heard thousands of shocking stories about what happened when people left had hospital without the right planning and support.
“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.”
Bradley added: “Whether it is about properly helping new mums at risk with depression, or making sure the patients receiving end-of-life care are given the support they need to spend their final days at home with their loved ones rather than in hospital, everyone should experience a safe, dignified and well-planned transfer of care.”
Peter Carter, chief executive and general secretary of the Royal College of Nursing, said: “Sadly, this will not come as a surprise to nursing staff, who all too often discharge a healthy patient only to see them return to hospital with complications caused by a lack of community care and support.”
Carter, blaming “systemic problems caused by increasingly fragmented services”, added: “With the right support in the community and properly resourced staff, who can be responsible for coordinating discharge, patients are less likely to return to hospital, relieving the pressures on the frontline”.
A Department of Health spokesperson said: “Care for the most vulnerable people is improving, including coordinating care for at-risk patients discharged from hospital. We have published a guide to help spread best practice and our £5.3bn Better Care Fund is getting local councils and NHS services working together more effectively to make sure people are properly supported when they leave hospital.
“But this report shows that we need to do more and we’re working with Healthwatch England, the NHS and others to improve further.”
The Health Service Ombudsman, Julie Mellor, said: “When patients are discharged unsafely from hospital it can have a devastating impact on them and their families.
“Our own casework shows that we still see too many complaints about failures in the discharge process. This report … adds further weight to our own view that there is still a way to go for the NHS and social care services to plug the gaps in their services to help achieve integrated, joined-up care for patients.”
NHS England said: “It’s important that patients who are well enough to leave hospital can do so at the earliest opportunity and are treated with dignity and compassion. However, we also need to ensure appropriate care is put in place before a patient leaves hospital, which needs strong joint working across the health service. While this can cause delays, it’s clearly better for patients and prevents a revolving door scenario that places greater pressure on the NHS.” ………………’
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