Poorly planned discharges with patients sent home from hospital alone, afraid and unable to cope and without care plans have been criticised for causing “untold anguish” by a health watchdog.
The Parliamentary and Health Service Ombudsman catalogued a series of “harrowing” cases in its publication A report of investigations into unsafe discharge from hospital published today.
These included a confused patient with a catheter still inserted discharged to an empty house, a distressed elderly woman’s family only informed hours before she was transferred to a nursing home and a man with dementia locked on a psychiatric ward for nine months after his local authority refused to fund a place in a dementia care home.
Chairwoman Dame Julie Mellor said: “The people that come to us have been badly let down by the system. How else do we describe the actions of a hospital sending a vulnerable 85-year-old woman with dementia home without telling her family, despite being unable to feed herself or go to the bathroom? How else do we describe the tragic story of a woman in her late 90s who was discharged without a proper examination, to then die in her granddaughter’s arms moments after the ambulance dropped her off?”
She said bereaved families said traumatic discharges added to their pain and grief.
The ombudsman said its caseload on unsafe discharges had soared by a third between 2013 and 2014-15 when it looked into 221 complaints, upholding half of them.
It said it only saw a fraction of cases and across the NHS there were 6,286 cases – a 6.3% increase on the previous year.
The watchdog found patients were discharged before they were ready, not assessed properly or consulted.
It said in many cases it investigated families and carers were not informed about patients’ discharge and no care plan had been put into place or patients were kept in hospital because of poor co-ordination across services.
The report called for better co-ordination within hospitals and with acute and non-acute services and social.
The NHS Confederation’s deputy director of policy Phil McCarvill said although most discharges were successful the cases highlighted by the ombudsman were “unacceptable”.
The Confederation’s report on its commission on Improving Urgent Care for Older People set out the importance of planning discharge from the moment a patient arrives in hospital and working with them as “active partners”.
“It’s vital that all of us – including government and national bodies – align around the common goal of transforming services to better meet people’s needs. Underfunded social care services continue to put immense pressure on NHS services and hamper efforts to improve care. This must be addressed by government,” said McCarvill.
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