Let’s get you home, but let's make it real
‘Let’s get you home’, but ‘Let’s make it real’
A cancer patient told us about leaving hospital with no advice or information, and then ending up back in A&E a week later.
The quality and consistency of care planning
Old and frail people routinely leave the Royal Sussex County Hospital without proper discharge plans or advice. Community support often fails to meet expectations and does not help people cope independently at home.
We interviewed 80 people in hospital and followed up on 49 people two months later at home. 41% of those who took part were over 80 years old.
Our findings
What we discovered:
- 59% people felt they were not involved or only partly in decisions about their care. Over half of these patients 53% felt they had not been asked for their opinion
- 39% of all patients felt the advice they had received while in hospital was not good enough to prepare them for being at home. 44% of all patients felt they were either not ready or only partly ready to return home.
- At the time we spoke to hospital patients, only 3% had received written advice on discharge planning, 11 people had received a hospital discharge letter, and only two people had received a written care plan.
What people want:
People asked to be more involved and to have their opinions considered in the decisions made around their discharge. Patients and staff highlighted the need for a consistent and standardised approach in discharge planning.
The majority of people are likely to return to their own homes. It is important that those living alone and unsupported are distinguished from patients who have a strong supportive network of friends and/or family.
Serious concerns
This review raises serious concerns about the quality and consistency of care planning and a lack of coordination and personalisation of care.
Fran McCabe, Chair of Healthwatch Brighton and Hove said:
David Liley, Chief Officer, Healthwatch Brighton and Hove said:
Our Recommendations
We identified recommendations in four areas:
- Communication
- Personalised care
- Delayed transfers of care
- Independent living
For details on our recomendations see below.
Plans to integrate
The NHS and Brighton City Council are making plans to better integrate health and social care in the City. The way the NHS is managed in Sussex and East Surrey is changing with much closer alignment of Commissioning – purchasing health and care services, over that region.
The whole health and care system is dealing with higher demands and funding pressures, many quality and performance targets are not being met and GP’s in the City have much higher numbers of patients to treat than in other parts of the country.
In September 2016 the number of patients per GP in Brighton and Hove was around 2,350, currently it is 2,805 patients per GP. The third worst in England, with the national average standing at one GP per 2,114 patients.
In this context, we asked local older people about their experience of getting advice and support when being discharged from hospital to home.
In Response
In December 2018, we provided an Interim Report to the local NHS and City Council.
We welcome the response from the Brighton and Hove Clinical Commissioning Group (CCG), who pledged to act to improve the information and advice given to people on discharge from hospital and on our other recommendations.
For more information
For more details on the report including our recommendations and the CCG response.
For interviews
Please contact David Liley, Chief Officer, Healthwatch Brighton and Hove.
dliley@healthwatchbrightonandhove.co.uk
07931 755 343