/ Health

Too many problems when patients leave hospital

People leaving hospital

Leaving hospital should be a happy time, showing you’re on the road to recovery and ready for some home comforts. So why are so many patients reporting a poor experience?

In the 21st century shouldn’t we expect some basic kindnesses to form part of our NHS?

What about helping an over-burdened carer get their sick relative and belongings to their car? Or making sure a vulnerable older person gets food and drink while they’re waiting to leave hospital.

Problems when leaving hospital

Our survey of nearly 2,000 inpatients and carers showed that the majority rated leaving hospital positively, but half reported specific problems for the patient. Poor communication affected a quarter.

One daughter told us that her frail mother developed pressure sores after being left for eight hours in a waiting room, thirsty and hungry.

You might think that – in these cash-strapped times – there’s nothing left in the pot for all but the essentials. But, as Sandra Wall of the Wirral Older People’s Parliament told us, it doesn’t have to cost money.

Her older people’s lobbying group worked with the local council to make some simple changes that really made a difference. These included introducing short-stay parking spaces outside the discharge lounge and organising volunteers to help newly-discharged patients.

Time to talk and listen

We’ve heard the word ‘dignity’ a lot in recent times, and isn’t that what a lot of this is about? Patients and carers need to know what plans are being made for when they leave. And it’s important that all the medication and services they need is written down, with a copy to the GP, so a poorly patient knows what to expect.

Maybe I’m naïve about the constraints on busy wards, but it seems to me that some of the indignities we’ve heard about wouldn’t happen if staff took the time to talk – and listen – to patients. And surely that doesn’t cost money?

Anne says:
28 October 2010

My father was hospitalised and diagnosed with diabetes and a brain tumour. My mother (who’d gone through the shock of him collapsing and being hospitalised) had been visiting him by bus so she didn’t have the stress of driving, paying for parking, etc, but planned to drive and collect him whenever he was discharged – and also planned to get things ready at home for his return.

Except they didn’t warn her before they discharged him.

She went to visit him – she thought – and found him sitting on his bed, in his coat, looking confused. It was the last straw. My mother burst into tears. She hadn’t got anything ready. She didn’t even have the car with her. The hospital felt so bad they called a taxi, but honestly, couldn’t they have warned her first so she could’ve got things ready?

The previous Government spent and committed to spend a fortune on computerisation of the NHS. However, the things that would really have helped patients have never been successfully brought to the front.
Examples that come to mind
1) The example shown above and reproduced in painful daily detail
2) Discharge letters, a recent family experience was a 10 days AFTER discharge.
3) A discharge was delayed for 24 hours because no one knew what was happening…
4) Discharge medicine, once this only took about 5 hours, the last time it took 36 hours, yesterday we decided not to wait… the patient has free prescriptions for her condition and we ensure that she has enough of her essential supplies anyway. We decided that thanks but no thanks was the way forward.
5) Why is there no way for patients to have discharge letters, medicine and other essential needs preprogrammed out of the very expensive but non working IT system?
6) Perhaps the books that need to be manually filled in by nurses who spend hours ticking off entries that are clearly too time consuming to result in any real action.
6) I am not making this up, we spent Monday evening while a nurse spent upwards of half an hour painstakingly ticking and recording details of everything from hand rails to bathrooms to the number of floors, to where the patient slept, washed and went to the loo. But for what? This was NOT nursing, it was not support, it did not result in any improvement in the discharge process or the provision of medicine which is probably now trying to find its way back to their pharmacy.

Sue Shaw says:
1 November 2010

When I left hospital after major surgery for bowel cancer my main concern was the lack of help from my local GP practise. They were no help what so ever. Eventually my local hospital sent a nurse out to me who went round to the surgery and blasted them. From then on they did help but very reluctantly. Do others have problems with their GP practises or is this another subject all together.

From one experience of mine, it looks as though the lenght of stay and so timing of leaving hospital can affect patient care, too.

Because I was in a hurry to get my hernias repaired, I paid to have them done privately. The surgeon insisted in me staying in hospital overnight afterward. This didn’t seem to affect how much he earned, but it did enable the nurses to make more extended checks on me until early next morning. It also left me under the care of a resident doctor and with a port still in place in case I needed some urgent medication. My surgeon complained that for the same operation at the nearby NHS hospital, he had to do the operation on day stay with patients leaving after only a few hours recovery. He did not find this satisfactory.. When I mentioned this to my GP some time later, he said bitterly – thats right, and its us GPs that have to pick up the pieces when things go wrong !

I wonder whether emergency re-admissions to NHS hospitals affect their performance statistics or funding.

gerald says:
29 November 2011

After the damning report by the care quality commission with regards to the bad treatment elderly patients are receiving in hospital i am awaiting another undercover report of hospitals carried out by which? The same as they did for care homes then maybe the public might get a more balanced viewpoint

gerald says:
13 February 2013

Well well, after all the recent reports detailing the awfull state of care at Mid Staffs Hospital where it appears that between 400 and 1000 people may have died prematurely the lack of response from Which? and others is deafening !!
It appears there is a list of Hospitals with similar reputation to Mid Staffs why isnt Which? “naming and shaming ???

Gerald says:
23 February 2013

Whilst at our local ,brand new,super dooper, £50million pound Hospital having a Catheter removed in outpatients I was told by an 80 year old of his experience
After having his appliance fitted he was sent home on the understanding that his GP would be informed when he was to return ,this applied to all present, which for 9 out of 10 this was in the region of 7 days, in the case of the old man no notification arrived and after 8 weeks and considerable discomfiture his daughter decided to take him back to hospital where they informed that his notes had been lost in all the excitement caused by the Queen,s visit for the official opening.Luckily the old man had managed to keep himself clean as he ” didn’t,t want to be a nuisance”

We aIl know about the disproportionate number of hospital beds which are blocked with patients who have finished their treatment but cannot be discharged because they have no one to look after them at home, they are too frail to look after themselves etc. I feel a bit diffident about making a suggestion in case it is too obvious, but I would have thought that it would be cheaper for the NHS to move elderly and vulnerable patients into the care of the local council when treatment is complete. Negotiate a rate with the council and get them to sort out the care homes on the strict understanding that it would be for a limited time. I should think you could afford to be comparatively generous and still show a profit!

O.K. They shouldn’t have done away with the Cottage Hospitals; but Care Homes will appear as if by magic when citizens can smell money!!!

Gerald says:
23 February 2013

Your idea is far from new,Nursing Homes have been contracting with the NHS for years and prices were set at approx.25% to 50% of the price previously paid tto the trust from which the patient was transferred , then came along the PCTs and in conjunction with the Local Authorities introduced a means tested scheme where bye the LA pay approx.£500 per week for clients with less than a total capital worth of £23000 and make others (the majority) fund themselves the PCTs kindly then donate £108 which is non means tested The PCTs still have the funding to fund ALL care in Nursing Homes as before but this is very rarely used. I am sure even you can see the injustice of the above system, you will also interested to hear that the money grabbing citizens you refer to we’re never consulted at any stage and were presented with this scheme on a “take it or leave”basis which is a regular way the LA treats us.
Our regional associations have now taken numerous LA,s to Court and obtained numerous successful judgements against.them.
I would be grateful in future before making such derogatory statements against the Private Sector,you would make some efforts in obtaining a more balanced picture.
There is a considerable amount of mud slinging going on ,mainly against the Private Sector and mostly generated by the Public Sector I don’t suppose for one minute that you are a part of this, are you?
Try talking to the numerous clients (over 400000 ) in Care Homes around Britain and ask them why they take their hard earnt money to these evil money grabbing Citizens whom you refer to.
You just might be surprised to hear that we have hundreds of thousands of satisfied clients, but of course the BBC and others do not think this is worthwhile, they are to busy protecting do good ears such as Jimmy Saville and friends .
To summerize, YES your idea has considerable merit and if administered fairly would save the NHS many millions of pounds so my question is why is it not happening I wonder? The answer can not be of the financial nature to which you refer.