Media release from Healthwatch Gloucestershire
27 March 2017
Healthwatch Gloucestershire publishes Hospital Discharge Review
Healthwatch Gloucestershire (HWG) is today publishing a review of the progress that local NHS and social care services have made in improving arrangements for people leaving hospital, since its report on the issue in November 2015 which made recommendations for change.
HWG again listened to people around the county to find out about their experiences of leaving hospital. It also visited the discharge waiting areas at Gloucestershire Royal Hospital and Cheltenham General Hospital to meet people in the process of leaving hospital. Voluntary and community organisations working closely with people leaving hospital also shared their experiences with HWG.
The HWG review reports on many of the improvements that have been made in the system since November 2015, both locally and nationally. It also highlights the challenges that remain locally. These challengesechothose identified nationally, for instance in reports published by the National Audit Office, the Care Quality Commission, and the Parliamentary & Health Service Ombudsman.
By sharing individual's stories, the review demonstrates the impact these improvements have had upon the experiences of people and their families.
HWG found it encouraging that people’s experiences of being discharged late in the evening or at night, and/or in night clothes, which featured in the original report, did not feature in the feedback collected since its publication. There were also positive experiences of discharge planning, and of follow-up after discharge. Many people did not experience any problems. However, some of the other issues raised in feedback in the original report continued to feature in people's experiences, including
- a lack of follow-on care and/or support arranged or available for people leaving hospital
- discharge taking place before people felt ready, followed by readmission shortly after in some instances
- a lack of information-sharing with families, carers or other health or social care professionals involved in their care, or poor communication
- long waits for transferfrom hospital to care homes
- delays waiting for medication
- lack of clarity in the discharge summary shared with people’s GPs
- delays due to a lack of home care available
HWG has made the following recommendations:
- That Gloucestershire Clinical Commissioning Group (GCCG), NHS provider organisations and Gloucestershire County Council (GCC) continue in their ongoing work to address the recommendations made in HWG’s 2015 report
- That GCCG, GCC and NHS provider organisations carefully consider the evidence presented in HWG’s review, to identify what the findings reveal about current system weaknesses: in particular, that the following issues would benefit from continued efforts to understand performance:
- Information-sharing and communication with patients, their families and carers
- Arrangements for care/support for people when they get home from hospital, including the availability of reablement support
- Arrangements for organising medication for patients to take home when they leave hospital
- Arrangements for non-emergency patient transport
- Communication and integration between different elements of the health and care system, including discharge summaries
- That NHS provider organisations acknowledge the value of the ‘patient story’ to enable system learning, and look to gather patient stories of their journey through the hospital and beyond to illustrate qualitative patient experience that is not captured through the Friends and Family Test or other surveys
- That HWG continues to monitor people’s experience of being discharged from hospital, and conducts a further review in 12 months; as the experiences shared with HWG by people and their families and carers in the last twelve months, and the strong national focus on discharge from hospital, suggests that there is a continuing need to keep this issue under review locally, with particular focus on
- Communication and integration between different elements of the health and social care system
- Communication with patients, their families and carers
- Arrangements for medication for patients to take home when they leave hospital
- Care/support for people when they get home from hospital, including the availability of reablement support
- Arrangements for non-emergency patient transport
- The impact of the introduction of the Trakcare electronic patient record system at Gloucestershire Hospitals NHSFoundation Trust(GHNHSFT) on people’s experience of being discharged
- Capturing a greater breadth of experience from people leaving hospitals provided by 2gether NHS Foundation Trust (2G)
GHNHSFT said “the Trust has carefully considered the evidence presented in this review which has revealed continued system weaknesses and will work to make system improvements in the areas identified within the report… The Trust would welcome a further focused review in 12 months and will support any HWG activity in this area”.
2G said “It is clear from the findings of the HWG review that, as a whole system of health and care, there is more work to do in relation to hospital discharge. 2gether NHS Foundation Trust remains fully committed to working in partnership with our commissioners, other NHS Providers, community and voluntary sector organisations in addition to people who use our services, to guide the development and delivery of our mental and physical health care services for the future”.
GCC said “It was good to note the progress that has been made across a number of fronts in improving practice following your initial report. However, there are clearly areas where we can continue to improve, both from the limited feedback for us as a specific organisation and as a system, so we are happy to support the recommendation that we will continue in our ongoing work to address the recommendations made in your original report”.
ENDS
Contact: Barbara Piranty, Healthwatch Gloucestershire
Tel: 01452 504989
Email:
Website:
Editor’s Notes:
The Health and Social Care Act 2012, introduced Healthwatch as the new independent consumer champion for health and social care for adults and children existing in two forms; Local Healthwatch at local level and Healthwatch England at national level.
Healthwatch England provides guidance and support to all 148 Local Healthwatch organisations and receives information from them about local issues and concerns.
Healthwatch has the power to influence, through its statutory seat on the local Health and Wellbeing Board, using the collective voice of residents to influence health and social care decision-making at a local level.
Healthwatch Gloucestershire acts as a single point of access to the public for health and social care information and advice and has three main functions:
- To gather people’s views on and experiences of health and social care locally. In this way, community views will have real influence with those who commission and provide services
- To provide the public with local information to help them make informed choices about their health and social care needs. This information can be accessed either directly, through the Healthwatch Gloucestershire Information Database on the website or by calling one of the experienced Information Advisers
- To provide access to the Independent Health Complaints Advocacy service (provided by SEAP in Gloucestershire). SEAP supports people who need help to make a complaint about NHS services they have received
Local Healthwatch has an additional power to ‘Enter and View’ provider premises to see how well they are working, but does not replace or duplicate the role of the Care Quality Commission as official regulator.
Local Healthwatch enables people to give their views and concerns about the health and social care services they receive and understand how these views are used to build a picture of where services are doing well and where they can be improved. It also alerts Healthwatch England and the Care Quality Commission to concerns about specific care providers.
Issued March 2017
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