Review of discharge in Bedford Borough

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Summary of report content

Between May and October 2014, Healthwatch Bedford Borough conducted research to gather the views and experiences of people being discharged from hospital. In order to reach as many people as possible they developed a questionnaire, conducted five announced Enter and View visits , and held four focus groups to reach the homeless, the elderly, and people with mental health conditions of people. These three groups had been identified by Healthwatch England as being particularly at risk if hospital discharge was not carried out effectively. The report notes that communication between teams and organisations plays a crucial role and regular, face to face meetings between and within organisations is what works best. Many organisations, such as those providing support for the homeless, were not always included in the discharge process. On the other hand, according to the findings, the complex discharge team at Bedford Hospital has made significant improvements to patients’ journeys. The overall experience of discharge from Bedford Hospital was good with 81% of patients recommending Bedford Hospital to their family and friends. While there are many positives in this review, there are also individual cases where patients had been let down. The Enter and View reports were sent, and responded, to by the individual providers so there is evidence of improvements having already been made as a result of this piece of work. These improvements include: updated signage in the Bedford Hospital discharge lounge; a group of care home and nursing home managers has been formed to develop processes for discharges to care homes and; Bedford Borough teams are working closely with the hospital trusts to develop good multi agency teams. The reports finishes with three recommendations: improved communication with family members, between and within teams and with outside support organisations; a discharge information pack with information regarding the expected pathway be given to patients on admission; quick access to medication on the day of discharge. These final recommendations have been disseminated with the report to all those involved in the commissioning and provision of services with an invitation to work with Healthwatch Bedford Borough to ensure the improvements are implemented.

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General details

Report title 
Review of discharge in Bedford Borough
Local Healthwatch 
Healthwatch Bedford Borough
Date of publication 
Thursday, 20 November, 2014
Date evidence capture began 
Thursday, 1 May, 2014
Date evidence capture finished 
Friday, 31 October, 2014
Type of report 
Report
Key themes 
Administration
Communication between staff and patients
Complaints procedure
Continuity of care
Discharge
Engagement
Health inequalities
Health protection
Holistic support
Information providing
Integration of services
Lifestyle and wellbeing
Prescription
Service delivery organisation and staffing
Support
Healthwatch reference number 
Rep-5127

Methodology and approach

Was the work undertaken at the request of another organisation? 
No
What type of organisation requested the work 
N/A
Primary research method used 
Survey
How was the information collected? 
Outreach
If an Enter and View methodology was applied, was the visit announced or unannounced? 
Announced

Details of health and care services included in the report

Secondary care services 
Acute services with overnight beds
Discharge lounge
Psychiatry/mental health (hospital services)
Accident & emergency

Details about conditions and diseases

Types of disabilities 
Multiple
Types of long term conditions 
Mental health condition
Other
What type of pregnancy or maternity themes are included in the report 
N/A

Details of people who shared their views

Number of people who shared their views 
94
Age group 
All people 18 and over
Gender 
All
Ethnicity 
Mixed / multiple ethnic groups
Sexual orientation 
Not known
Other population characteristics 
Homeless people
Does the information include public's views? 
Not known
Does the information include carer's, friend's or relative's views? 
Yes
Does the information include staff's views? 
Yes
Types of health and care professionals engaged 
Administrative
All care professionals
Allied health care professionals
Care / support workers
Doctors
Nurses
Receptionists
Service manager
Does the information include other people's views? 
Not known
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? 
Yes
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.