Improving the experience of leaving hospital - our work with carers
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
Some findings that stood out to us:
- All people we interviewed thought that caring was a natural part of their role as a family member
- The recent hospital admissions almost always added pressure to the carer, and the level of care needed increased
- Most people mentioned extreme physical and mental fatigue
- Carers believed it was important to be involved in conversations about discharge to make sure that discharge plans were adequate and support was in place to make leaving hospital a success
What happens next
We have reported our findings to NHS England, 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. Here’s our latest update on action taken:
- Carers toolkit: NHS England worked with groups for Carers to develop a toolkit addressing many of the issues that carers told us about
- St George’s Hospital has committed to using the toolkit and will be sharing more information on their action plan soon
- Applications for extra funding have been made to make fast changes
- Urgent Care Plans (UCP) are being used more for patients with carers to prepare care for the possibility that their carer may no longer be able to care for them, and a process could be rolled out for this by the end of the year
- GPs are being given more resources to identify carers
- Payment support for some carers from their GP is being investigated as an option
- A dashboard is being created to help people in charge of health and care to better understand health needs of carers, like the higher numbers of hypertension and depression
- Relationships are developing with organisations reaching into the hospital to support carers, and community plans are being to developed to improve the out of hospital reach
- The council are developing a Carers’ Charter that is shared across organisations
- Social services have worked more closely with health partners to support carers
- Virtual Wards are developing to ensure that specific information that carers need is provided
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.
