Agenda item

The Committee considered a report of Healthwatch Leicester and Leicestershire which presented their findings from two pieces of work on hospital discharge. A copy of the report, marked ‘Agenda Item 10’, is filed with these minutes.

The Committee welcomed to the meeting for this item Sarah Taylor, Director of Urgent and Emergency Care, University Hospitals of Leicester NHS Trust.

Arising from discussions the following points were noted:

(i)           The patients spoken to by Healthwatch were from both Leicester and Leicestershire. The data was not disaggregated.

(ii)         The data set of those interviewed was relatively small compared to the numbers of patients discharged in Leicestershire – UHL discharged approximately 10,000 patients a year. A member therefore questioned the significance of the findings in the Healthwatch report and how much emphasis could be placed on the feedback. In support of the findings, UHL explained that they recognised the themes in the Healthwatch report from other feedback that they received.

(iii)        Healthwatch Leicestershire had previously undertaken a research project on hospital discharge in October 2020 to follow up on visits to the discharge lounges at local hospitals in July 2019. Members raised concerns that there did not appear to be much improvement with discharge in Leicestershire since that original research was carried out.

(iv)       Members echoed the findings of the Healthwatch reports and reported that they had received similar comments from local residents particularly in relation to poor communication with patients and a lack of medication readiness. Members were disappointed that only 58% of respondents felt involved in discussions about their discharge. In response UHL acknowledged that some patients felt they were discharged with insufficient information, and UHL provided assurance that work was taking place to improve the clarity and consistency of communication with patients about their discharge. Even if UHL felt they were providing a lot of information, work needed to take place to improve the perception of patients and make them feel more informed.

(v)         Members raised concerns that patients did not always receive written communication about their discharge and that, where they did, this sometimes contradicted what they had been told verbally. UHL acknowledged that further education of staff needed to take place to ensure that verbal communications re-iterated what was written down but stated that some of this good practice was already taking place.

(vi)       The Patient Advice Service was a point of contact for patients if they needed any information about their discharge.

(vii)      Members raised concerns that carers felt uninvolved in the discharge process and only 16% of carers were informed of their right to a Carers’ Assessment. In response it was acknowledged that carers needed to be provided with timely information and explained that the Carers’ Assessment took place out of the hospital setting around 10 days to two weeks after the patient had been discharged from hospital into their own home. This gave the patient a chance to get stabilised before the assessment took place.

(viii)    Some Adult Social Care staff were based on the hospital wards so they could be involved in discharge discussions at an early stage. It was important that patients received a copy of their Care Plan and the contact details for their care provider before they were discharged, and also that carers were made aware of what processes were to follow.

(ix)       Whilst the Adult Social Care Team mainly supported complex discharges, wellbeing checks were also undertaken on patients that did not have a Care Plan.

(x)         Patients on an end-of-life discharge pathway could be fast-tracked and they would receive their equipment at their home or care home within 24-48 hours.

(xi)       In response to queries about a lack of respondents from community hospitals in the Healthwatch research it was clarified that Healthwatch had carried out a separate piece of work relating to Enter & View visits to community hospital discharge wards.

RESOLVED:

That the findings of Healthwatch Leicester and Leicestershire’s work on hospital discharge be noted with some concern.