Healthwatch England has called for national change to the process of discharging people from health and care settings, following a special inquiry which has underscored the human and financial cost of poor and unsafe discharges from health services.
With more than one million emergency readmissions within 30 days of discharge in 2012/13 alone, costing an estimated £2.4 billion, the organisation said on Tuesday that the time has come for "concerted action and coordinated national leadership to ensure the discharge process meets people’s needs."
Publishing Safely home: What happens when people leave hospital and care settings? on 21 July, the consumer champion has challenged the health and care sector to do more to improve the experience of people leaving services. The NHS Confederation has welcomed the report's focus on joined-up care.
Key issues with discharges
Safely home draws on more than 3,000 pieces of evidence about people's experiences, focusing on those with mental health conditions, older people and homeless people. It reveals five key reasons why patients and care users say their departure was not handled properly:
- People are experiencing delays and a lack of coordination between different services.
- People are feeling left without the services and support they need after discharge.
- People feel stigmatised and discriminated against and feel they are not treated with appropriate respect because of their conditions and circumstances.
- People feel they are not involved in decisions about their care or given the information they need.
- People feel that their full range of needs is not considered.
Punctuated with stories of care users' experiences, the report also highlights examples of initiatives that are helping to resolve the difficulties people have experienced. But it concludes: "Without good practice being adopted more widely, the problems and the costs to both individuals, their friends, families and the system will continue."
Responding to the report, Phil McCarvill, deputy policy director at the NHS Confederation, said: "Our members are already making progress in connecting different health services and delivering individualised, person-centred care, and will be keen to reflect on Healthwatch’s findings.
“The scale and complexity of the NHS can sometimes make the experience of care feel less tailored to individual’s needs. Delivering compassionate, dignified care must be the top priority of everyone who works in the NHS and change is needed wherever patients’ experience falls below that standard."
With no one-size-fits-all solution, he said local leaders will need to continue working with key partners, such local authorities and the voluntary sector, "to shape services and ensure the delivery of care in the right way, the right place and at the right time."
Practical and personal
Mr MaCarvil added that making services more joined-up is also helping to bring mental and physical care closer together, "which is a priority as the NHS strives to improve its support and identification of poor mental health.”
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