Hospital Discharge Day Thursday 7th July 2016, 9am – 2pm Lewis Carroll Room, Orford Jubilee Hub, Jubilee Way, Warrington, WA2 8HE

Healthwatch Warrington Experiences Deborah Dalby Chief Executive Office Healthwatch Warrington Tel: 01925 246 892 Email: contact@healthwatchwarrington.co.uk

Hospital Discharge The Bigger Picture 2015 - 2016

The National Healthwatch Picture 'Safely Home: What happens when people leave hospitals and care settings?' brought together 3,230 stories and pieces of evidence, gathered by 101 local Healthwatch from across the country (including Healthwatch Warrington),revealing the cost of getting the discharge process wrong. Key issues were identified including poor communication and coordination between services and people not being involved in planning their discharge. The report highlighted that discharge processes are at their best when everyone looks beyond service boundaries and shares responsibility for ensuring people get home safely.

'Safely Home: What happens when people leave hospitals and care settings?' The report identified a number of basic common issues including; 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 & Families not being notified when loved ones are discharged. In 2014 the National Audit Office reported that in the space of a year the NHS deals with one million emergency readmissions within 30 days of discharge, costing an estimated £2.4 billion. Whilst not all of these cases are the result of a poorly managed discharge, Healthwatch England's patient-led investigation found that 17% of those being readmitted for the same issue in the past three years are returning to hospital within just seven days, suggesting a problem with the current process.

This is by no means a new problem, but the report highlighted the consequences of unsafe discharge and outlined the potential for savings by getting discharge right first time. The report described some excellent examples of discharge being managed well e.g. Royal Pharmaceutical Society, My Discharge Project – Royal Free, Care Navigators in Waltham Forest, proving that the challenges of working across service boundaries can be resolved - but there is considerable variation up and down the country and a need for the good practice to be spread. Healthwatch England's call to everyone in health and social care was not just to hear what these 3,000 plus voices have a say, but to take action and devise a collective plan to tackle the issue of discharge. A first step was taken in mid 2015 when Healthwatch England and the Department of Health brought together all those organisations with an interest in getting this right in the future.

5 Areas Where the Health and Social Care System Needs to Improve Focusing on those most affected by poorly managed discharge processes (those with mental health conditions, older people and homeless people) the report revealed five areas where patients and care users said there are issues; People experiencing unsafe, delayed or untimely discharge due to a lack of co-ordination between health, social care and community services. A lack of support available for people after discharge, often leading to readmission.

5 Areas Where the Health and Social Care System Needs to Improve Many people felt discriminated against or stigmatised during their care, often feeling 'rushed out the door‘. People did not feel involved in decisions about their ongoing care post discharge. Individuals’ full range of needs were not considered when being discharged from hospital or a mental health setting – including their housing situation, carer responsibilities etc.

What People Want from Discharge To be treated with dignity, compassion and respect. For their needs and circumstances to be considered as a whole - not just their presenting symptoms. To be involved in decisions about their treatment and discharge. To move smoothly from hospital to onward support available in the community. To be properly informed about where to go for help after discharge.

Time for Change The report does not include recommendations, instead posing a challenge to the health and social care sector to take action to improve people’s experience of leaving services. Healthwatch England believe that because there has been no single body responsible for this issue, there has not been the leadership to tackle poor discharge from health and social care services. This has been supported with leadership from the Department of Health in working with Healthwatch to bring together partners and services to develop collective plans to tackle the issue and track progress. Healthwatch locally and nationally will continue to engage with the voluntary sector and other organisations to ensure that this issue remains a priority.

Time for Change Healthwatch England continue to support local Healthwatch to work with providers, Clinical Commissioning Groups and Health and Wellbeing Boards to focus on the issues highlighted by this piece of work. As well as promoting services that are getting discharge right, Healthwatch across England have shown that, in partnership with the voluntary sector, they can make a significant difference by highlighting poor practice and championing the need for change. Healthwatch believe that joint action can deliver changes needed to make significant improvements to the experiences of people leaving hospital and care settings.

The Report To download the report or find out more, visit: www.healthwatch.co.uk/safely-home

Round Robin Why does Hospital Discharge matter to you? Esstta Hayes Community Engagement Officer Healthwatch Warrington Tel: 01925 246 894 Email: esstta@healthwatchwarrington.co.uk

Hospital Discharge in Warrington Sue Rohan Matron Warrington and Halton Hospitals NHS Foundation Trust Tel: 01925 635 911 (ext 290)  

Discharge & What it means for Carers Julie Howson G.P. Liaison & Hospital Discharge Coordinator for carers WIRED Adult and Young Carers Services Warrington Tel: 01925 633492 Email: wcsadults@wired.me.uk