Too many people are being discharged from hospital unequipped and ill prepared to support their own recovery at home, research from the British Red Cross has shown.
The charity said that while there are many examples of good practice initiatives that are making a real difference to the home from hospital experience, there is a lack of consistency of provision and too many people are still “falling through the gaps” with unmet needs.
The research found that some people returned to their homes with no hot water or heating, while others with changing mobility needs reported struggling with a step up to a front door, or felt unable to get upstairs to the toilet.
The British Red Cross research is based on interviews with people across the UK who were recently discharged after an unplanned stay in hospital without social care, as well as conversations with their carers and hospital staff.
This is supported by a survey of hospital discharge checklists in England, which found that only half include information on whether a patient will return to a suitable home environment, with basic essentials such as food, water and heating.
Researchers observed a number of examples of poor patient experience that seemed to stem from insufficient communication and poor hand-offs between teams and individual staff.
Some of the patients who took part in the research didn’t know what support was available that could help them prepare for their hospital discharge and recovery and they often didn’t know who to ask.
Many people who were interviewed were also unclear about what their discharge notes meant, who they were intended for and who else had been – or should be – given a copy.
The British Red Cross has called for clearer lines of accountability for ensuring a recovery-focused patient journey through hospital and home again, and said that people’s non-clincial needs should have parity of esteem with their clinical needs.
“There is a substantial opportunity for commissioners and providers to harness the power of non-clinical support, including the voluntary and community sector, to relieve the pressure on the NHS and to create better outcomes for people and improved patient flow within and between health and social care providers,” the charity argued.
“Every point of hand-off between clinical teams in hospital and from the hospital to the community is a potential point of success or failure for patient recovery. We recommend that there is a clinical responsibility to ensure the effective management of these transitions, so that there is continuity of care and patients don’t fall through the gaps between teams.”
The British Red Cross has also recommended a five-part ‘independence check’ to be completed as part of an improved approach to patient discharge:
- Practical independence (for example, suitable home environment and adaptations)
- Social independence (for example, risk of loneliness and social isolation, if they have meaningful connections and support networks)
- Psychological independence (for example, how they are feeling about going home, dealing with stress associated with injury)
- Physical independence (for example, washing, getting dressed, making tea) and mobility (for example, need for a short-term wheelchair loan)
- Financial independence (for example, ability to cope with financial burdens).