Our work with carers to improve what happens when you go home after a hospital stay

Report - 20 May 2022

Thanks to people who spoke to us about caring for someone who was discharged from hospital, we have influenced a wide number of developments in support for carers and people discharged from hospital.

During the pandemic changes were made with the aim of discharging patients at an earlier stage and supporting home-based care arrangements. Carers are often involved in supporting people once they are home, and there was a need to understand how involved carers are in the discharge process and arrangements due to their important role in a patient’s recovery. Carers play a key role in helping people get better, they know a lot about the person being cared for and what can help them recover. They see things that staff cannot see and can respond to emergencies to get help quicker. Improvements to involve and support carers should lead to better discharges and save time and resources for all involved. NHS England (NHSE) approached us and other Healthwatch to undertake local research as part of a national study.  

What we did

We interviewed 10 carers between 8th December 2021 and 22nd February 2022. We then reported the findings to local staff across organisations who work on supporting hospital discharges in March 2022. Findings across the Healthwatch were compared to compile a national report on the issues or areas that could improve hospital discharge for carers and patients. Locally we will be following up the findings with organisations operating in Wandsworth.

Key findings and recommendations

There were carers who had varying experiences, some positive and some identifying issues or room for improvement. We identified themes to focus on to ensure a positive experience for carers and improved hospital discharge processes. These included:

  • Identification of carers and their caring role
  • Communication and information
  • Timing of discharges
  • Assessment of carer/caring need post discharge

Read our report for more about what was important to get right to improve hospital discharges.

What happens next

We have reported our findings to NHS England, who are collating the results nationally and will be reporting soon. They have said their next steps to bring improvements include:

•raising awareness of information about how carers can access support and get what they need when supporting someone who has left hospital.
•NHS staff working in hospitals and the community as well as GPs will be encouraged to identify carers at an early stage using appropriate questions and to not just rely on assumptions. The knowledge that the carer brings of the patient, their condition and home circumstances as well as their own situation should be properly understood. Carers should be part of leaving hospital conversations and decisions so that they are fully informed and have the available knowledge (and equipment) and back-up to be able to provide appropriate support, within their abilities, after the patient leaves hospital to ensure safe discharge and reduce the chances of either patient or parent going in to crisis.
•a suite of ‘quality markers’ is being developed to document what needs to happen from a carer perspective so that hospitals can measure themselves against best practice. This mirrors the approach already developed for primary care.
•The use of carer passports will be encouraged with an emphasis on schemes that straddle community settings and hospital settings to ensure continuity.
•To support carers in their caring role there also needs a more formal way of producing a contingency plan that is accessible to key professionals so when circumstances dictate that a carer is not able to provide that care, that appropriate arrangements are made to support the cared-for person.
 
We have presented these findings to local decision makers and people working at a London level. We will continue to find out what improvements can be made to take account of what carers have told us will improve hospital discharges. The insight we gained in this piece of work will also be useful to inform other new initiatives, such as plans to deliver more care in people's homes.

Support for carers currently in Wandsworth:

If you help someone in Wandsworth with their day to day living. One key place to look for advice and support is Wandsworth Carers' Centre. They can signpost you to many other sources of support that you might need.

You can also speak to the council or the Carers' Centre about an assessment.

More information is available here

Helping someone else, our own health and wellbeing can take second priority, but we would encourage everyone to make sure they think about maintaining your own wellbeing to help you and the person you care for. You can speak to your GP and they will give you longer appointments if you are a carer. It is also worth considering how to maintain mental health wellbeing and the Carers Centre and Talk Wandsworth could help. 

Read more in our report

Healthwatch Wandsworth Carer Experience of Hospital Discharge Report
Download (PDF 342 KB)

You might also be interested in