Enter and view: Hospital discharge, Queen Elizabeth Hospital

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Summary of report content

Hospital discharge was raised as a priority for Healthwatch Greenwich especially after two subsequent CQC reports rating the service at Queen Elizabeth Hospital, first as ‘inadequate’ and the second time as ‘requires improvement’. Due to the lack of beds at the hospital the safe and efficient discharge of patients was essential for the smooth running of the hospital. At that time, it was running at 50% delayed discharge. To consider the issues around hospital discharge in QEH, HW did a focus group discussion on February 16th which aimed to bring patients, carers, residents, and professionals together to discuss their experiences of hospital discharge. It also scheduled enter and view visits to the discharge lounge at QEH to talk with and gather feedback from patients who are preparing for discharge. In the focus group, round table discussions were set up to hear personal experiences and ideas about best practice. The discussion looked at discharge considering homelessness, communication, continuity of care, beds available, medication and finding alternatives to A&E. The HWG team then conduced four scheduled E&V visits to the discharge lounge at QEH to gather feedback from patients who were scheduled for discharge. They reviewed the discharge service in light of environment and cleanliness, treatment by healthcare staff, readmission, bed usage and delays, communication throughout admission, information about the discharge process and support services available, involvement in the decision making around leaving hospital, housing and family/community support after discharge and medication. HW team made a few recommendations Consideration should be given to the patient’s own feelings about whether they consider themselves ready for discharge. The hospital should produce a discharge checklist, which lists all services that the patient could be referred to with contact details and how to access them. Clear information about the discharge process should be given to all patients when they are first admitted. Where additional needs are identified, these should be assessed for and put in place well before discharge. The discharge lounge should not be used as an overflow for other wards in the hospital. Lewisham and Greenwich NHS Trust, Greenwich CCG and RBG must work together to jointly commission and fund an increase in suitable short and long-term beds to ensure that patients can get the care they need outside of the hospital setting in a timely manner. They should also commission a ‘task force’ to go into services recently rated inadequate and tackle the identified issues, with a view to returning the embargoed beds into full use. Patients being discharged, who have been prescribed medication by the hospital, must be fully informed of how and when to take the medication. The service providers response and actions to be taken are included in the report.

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General details

Report title 
Enter and view: Hospital discharge, Queen Elizabeth Hospital
Local Healthwatch 
Healthwatch Greenwich
Date of publication 
Friday, 16 June, 2017
Date evidence capture began 
Thursday, 16 February, 2017
Date evidence capture finished 
Friday, 17 March, 2017
Type of report 
Enter and view
Key themes 
Communication between staff and patients
Continuity of care
Cost of services
Discharge
Medication
Quality of treatment
Staff levels
Healthwatch reference number 
Rep-1343

Methodology and approach

Was the work undertaken at the request of another organisation? 
No
Primary research method used 
Focus group
Observation
How was the information collected? 
Visit to provider

Details of health and care services included in the report

Secondary care services 
Acute services with overnight beds

Details of people who shared their views

Number of people who shared their views 
15
Age group 
All
Gender 
All
Ethnicity 
All
Specific ethnicity if known 
All
Does the information include public's views? 
Yes
Does the information include carer's, friend's or relative's views? 
No
Does the information include staff's views? 
Yes
Types of health and care professionals engaged 
Care / support workers
Does the information include other people's views? 
No
What was the main sentiment of the people who shared their views? 
Mixed

Outcomes and impact

Were recommendations made by local Healthwatch in the report? 
Yes
Does the information contain a response from a provider? 
Yes action has been taken or promised
Is there evidence of impact in the report? 
Yes
Is there evidence of impact external to the report? 
No
What type of impact was determined? 
Implied Impact
Tangible Impact (cost related)
Tangible impact (not cost related)

Network Impact
Relationships that exist locally, regionally, nationally have benefited from the work undertaken in the report
 
Implied Impact
Where it is implied that change may occur in the future as a result of Healthwatch work. This can be implied in a provider  response, press release or other source. Implied impact can become tangible impact once change has occurred.
 
Tangible Impact
There is evidence of change that can be directly attributed to Healthwatch work undertaken in the report.