Patients are being left feeling “confused and neglected” by not being told who to contact about their future care when they are discharged from hospital, an NHS watchdog has said.
Research by Healthwatch England has found that 51% of people are not being given details when they leave of which services they can turn to for help and advice while they are recovering.
The NHS was risking patients having to be readmitted as medical emergencies and hospital beds becoming even more scarce by failing to adhere to its own guidelines on discharge, it said.
“While our findings show some positive examples, it’s alarming that guidance on safe discharge from the hospital is routinely not being followed,” said Louise Ansari, the patient champion’s chief executive. Healthwatch asked 583 people and their carers how their discharge had gone.
“Over half weren’t told who they could contact for help and advice about managing their medical condition after coming out of hospital, leaving them feeling confused and neglected,” she added.
That failure to share contact details was “counter-productive [because] this lack of knowledge increases the risk of patients soon ending up back in already-overcrowded hospitals or going to their GP”.
Healthwatch also found that 59% of patients discharged were not asked if they needed help getting transport home or to a care home or wherever they were going to – a clear breach of government guidelines, which obliged hospital discharge teams to arrange transport if needed, it said. The NHS needed to urgently improve discharge processes before it came under intense pressure this winter, when hospitals often ended up with too few beds for the surge in the number of patients cold weather brings.
A woman who sustained injuries including broken bones in her legs when she got trapped between two vehicles in Windsor told Healthwatch how she was given no help getting home to Herefordshire, several hours away, on her discharge from Wexham Park hospital A&E in Slough.
She had to get a taxi to the station and get home on her own because she had no family or friends nearby. She said: “Once the medical bit is done, you’re just sort of abandoned. I was just told to go home and rest. No follow-up plan was offered. No treatment plan, no pain relief, no numbers for support.
“When I got home I visited a private GP who told me that I in fact needed trauma follow-up and I’ve been getting treatment privately since then.”
Similarly, a 96-year-old woman called Gladys who had a bad fall in April was sent home after her operation with post-discharge support that her family, who care for her, thought was inadequate. It involved only limited physiotherapy, but not a spell in a residential rehabilitation unit, to help improve her mobility, despite her frail condition and the risk of falling again.
“No equipment was provided for us to help Gladys get moving again, like a Zimmer frame. The individual staff are caring but the system isn’t set up to help you get better”, Gladys’s daughter-in-law told Healthwatch.
She ensured Gladys did did a more comprehensive set of exercises than the NHS had recommended – action that the surgeon at her follow-up appointment said meant she would be able to walk again, which the exercises the NHS had advised may not have done.
Thea Stein, the chief executive of the Nuffield Trust thinktank, said politicians and the NHS did not give enough attention to discharging people safely.
“Our obsession with urgent care and a narrow definition of frontline staff means we don’t focus anywhere like enough on transitions from hospital to home, which is often patchy and can be bewildering and confusing for patients and their families,” said Stein, an ex-health trust chief executive.
“This approach is a false economy and can often end up with patients readmitted just days after leaving hospital. This is particularly troubling as the NHS is on the brink of yet another tough winter.”
A Department of Health and Social Care spokesperson said it was putting £1.6bn over two years into improving hospital discharge and that delayed discharges had fallen 13% since January.
“It is vital people receive the right care in the right place, and we are working to ensure patients are discharged safely from hospital, as soon as possible after they are medically fit to do so,” they said.
