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Brighton health watchdog says hospital needs to do more to safely discharge patients

by Jo Wadsworth
Friday 24 Jul, 2015 at 8:44AM
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Brighton and Hove’s health watchdog has praised the Royal Sussex for implementing its recommendations to improve how people are discharged – but says a report published this week shows more needs to be done.

Royal Sussex County HospitalThe new report comes in the same week NHS England figures showed the Royal Sussex County Hospital in Eastern Road has the highest rate of A&E waiting times over four hours in England.

The new Healthwatch England report – Safely Home: what happens when people leave hospital and care settings? – covered the experience of more than 3,000 patients, either older, homeless or with mental health problems.

“Shocking” lack of care for vulnerable people discharged unsafely from hospital has been highlighted this week by Healthwatch England.

Common basic failings identified in its report included hospitals not routinely asking patients if they have a home or safe place to be discharged to, details of new medications not being passed on to GPs and carers, and the failure to notify families when relatives were discharged.

In October 2014 Healthwatch Brighton and Hove published Leaving Royal Sussex County Hospital. Its findings were included in ‘Safely Home’. The report revealed that only 38% of people asked felt safe and confident to leave hospital, while only 35% said their medication had been explained to a carer or themselves.

The hospital discharge booklet, which explains what happens next and where to go for help and support after leaving, was scarcely used, and only 50% of those asked had received their discharge summary.

The report made 11 recommendations. Since then, Brighton and Sussex University Hospitals (BSUH) have worked hard to address these issues.

The Discharge booklet has been printed, and will be launched in ward areas over the next two weeks. Additional staff have been recruited to allow assessments to take place quicker and allow more rehabilitative therapy to be completed before leaving hospital.

New leaflet dispenser and notice boards have been purchased to display a greater range of information to help people back at home, including self-help groups, community services, and general advice (eg. falls prevention).

‘Discharge Hour’ has been reinstated. This means that medications are prepared 24 hours in advance, and early indications show that patient flow is improving as a result.

Hot water facilities have been re-instated in the toilet facilities of the discharge lounge.

Nevertheless, the number of people whose discharge is delayed remains stubbornly high. In many cases this is due to the complexity of the needs of people who need specialist housing or nursing care.

Nicky Cambridge, chief executive of Healthwatch Brighton and Hove said: “A delay in discharging people affects the whole hospital. Recent data shows that Royal Sussex County has the second highest rate of A&E waiting times over four hours in England and some of this is due to waiting for a bed to be available in wards.

“A focus on the quality of discharge planning and investment improves patient experience and has an impact on the rest of the patients in hospital who are waiting for beds, so we are really pleased to hear of the progress since our visit.

“However, delayed discharge does remain stubbornly high so Healthwatch B&H will continue to monitor discharge from the hospital. As ever, we urge patients and the public to get in touch about their experiences.”

A trust spokeswoman said: “Our aim is always to treat patients in our emergency departments as quickly as possible but when the hospital is as busy as it has been in recent months the reality is that there are times when patients have to wait longer than we would like.

“All patients who do have to wait in A&E are seen by a clinician within twenty minutes of arriving in the department, are made as comfortable as possible and are regularly monitored in a safe environment.

“We are aware this is happening too often and we are working extremely hard to improve the flow of patients through A&E by creating more space for patients within the whole hospital, as well as working with our partner health and social care organisations to create more space out in the community that will allow patients to be discharged from hospital quicker.”

If you would like to share your experience with Healthwatch Brighton and Hove call 01273 23 40 40, email: help@healthwatchbrightonandhove.co.uk or click here to submit a comment online.

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