A HOSPITAL trust has been asked to make improvements to discharge procedures after communication issues and gaps in care plans were reported by patients and staff.
Problems with hospital discharges at facilities overseen by the County Durham and Darlington NHS Foundation Trust were highlighted in a report published earlier this month.
Healthwatch Darlington says there has been a “lack of communication regarding all aspects of discharge” from those working within the area and patients, relatives and carers going through the process.
The organisation – which aims to improve health and social care provision by giving local people a voice – carried out surveys, held focus groups, visited hospitals and met staff before making recommendations for improvement in its Hospital Discharge Report.
While some respondents reported effective discharge procedures, others shared their “somewhat negative” experiences, with the report saying some patients felt completely abandoned upon their return home from hospital.
One person, who had undergone ten hours of surgery and chemotherapy, claimed they were discharged with “no actual support” made available while others reported delays around paperwork, medication and transport home.
Both patients and carers said they struggled to obtain information and were, in some cases, assumed to be willing and able to take on caring responsibilities for themselves or their loved ones.
One said the discharge team assumed she could manage her husband’s care at home, but added: “This subsequently meant I had to give up my job and become a carer – I get zero help from statutory services.”
Discharge staff also said they felt winter pressures had an impact on the discharge process but that they did their best to keep patients informed and to warn them about the process “to avoid any unrealistic expectations”.
One discharge nurse said they were compressing five days’ worth of work into two, due to a colleague’s sickness and said there were more people with complex needs being admitted, making it “more important to get the right support for people, especially if they are going home”.
Concerns were also flagged up by staff around a lack of rehabilitation beds in Darlington meaning patients from the area could be sent further afield to recover.
The report said frustration with the Trust’s discharge procedures was clear and called on CDDFT to review its policies to ensure “best practice is being adopted when dealing with both patients and carer” during the process.
In a bid to help them better understand complexities around discharge pathways, Healthwatch also said the Trust should consider more training for staff, especially in relation to patients leaving hospital with needs relating to both their physical and mental health.
A Darlington Borough Council spokesman said the authority supported the recommendation around communication and called on the Trust to communicate with patients and their loved ones both face to face and in writing.
He said the discharge team should work with families to plan discharges and “not just assume that the family carer is able and willing to pick up the caring role without additional support.”
A spokeswoman for the Trust responded to the concerns in the report and said the findings would be relayed to its Executive Patient Safety and Experience Forum, “ensuring wider understanding of senior management”.
She added: “The findings will also be disseminated to the operational discharge forum to ensure that any wider lessons can be understood and relayed to the frontline clinicians.”
The Trust’s current discharge policy aims to “ensure that unplanned re-admissions do not occur as a result of poor discharge planning” and sees patients given ‘Your Ticket Home’, a document detailing expected discharge date and information around medications, home settings, travel and future appointments.
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