Equipment and care needs unmet as COVID forces “rushed” hospital discharges

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Rushed hospital discharges during the coronavirus pandemic have led to unmet care needs and a lack of support for patients returning home, a major study has found.

The government issued a policy at the start of the pandemic to switch to a ‘discharge to assess model’ to help hospitals free up 15,000 beds and enable people to have their ongoing care needs assessed at home.

But a new report has found that 82% of respondents did not receive a follow-up visit and assessment from a health and care professional, with nearly one in five (18%) of those who did not receive a visit reporting unmet needs after leaving hospital.

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The study was conducted by Healthwatch England, in partnership with British Red Cross, and reviews the experiences of 590 people.

Eight local Healthwatch and partners around the country also carried out 61 in-depth interviews with key staff groups involved in hospital discharge processes.

Nearly half of people with a disability and 20% of people with a long-term condition said they had support needs that were not being met following their discharge.

Researchers heard that 25% of those who reported having outstanding support needs lived alone and that 74% of those still needing support were between 50-80+ years old, suggesting that there is a gap in the provision of post-discharge community health and social care services for those who are likely to need additional help.

Some patients felt that their discharge from hospital was rushed; approximately one in five people (19%) felt they were not prepared to leave hospital.

People with outstanding needs reported that they were unsure of how to manage their condition following discharge, including how to administer medication, and who to contact for further advice and support. Just 19% of patients were asked if they needed support taking medication.

There were also issues relating to the provision of mobility aids and other equipment in the home, and a lack of consideration of people’s home situation after they left hospital. Only 6% of people who had an assessment discussed equipment and mobility aids.

Paid carers echoed this observation and suggested that there was a lack of support and consideration for people’s home situations and living conditions.

Care professionals also reported issues that affected their ability to prepare for their client’s arrival after being discharged, with some patients being discharged too early and, sometimes, readmitted to hospital.

Healthwatch England and British Red Cross have urged the Department of Health and Social Care and NHS England to investigate these issues and called for the government to increased investment in community services.

“A clear benefit would be improvements to joined-up working between hospitals, community healthcare, the voluntary and community sector and social care services, fostering a more patient-centred approach to discharge and reablement. However, the model will only be successful if these services are sufficiently resourced in the community,” the report said.

British Red Cross Chief Executive, Mike Adamson, said: “As winter approaches and the pandemic continues, the British Red Cross is working alongside NHS and social care services to get people home safely from hospital. We’ve seen first-hand the huge efforts made to improve the discharge process for patients and their families. However, we also know despite good intentions and hard work, there are still barriers to making the ideals of discharge policy a reality.

“The Red Cross has been bearing witness to these issues for years, and we hope that the increased urgency of the situation will bring lasting change. Many of the people we support are older or more vulnerable, and fall into the higher-risk categories for Covid-19. Simple interventions, like getting equipment and medicine delivered, or follow-up visits, can make the difference between good recovery or someone regressing to the point of readmission – precisely at the time we want people to stay well, and stay at home.”

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Alex Douglas

The author Alex Douglas

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