Hospital discharge - what you need to know
According to recent news reports, so called 'bed-blocking' is on the rise, with thousands of patients experiencing delayed discharge due to a lack of available social care after leaving hospital. With hospitals undoubtedly under pressure, it is important that patients and their carers know what they should expect.
No one should discharged from hospital until their treatment is complete, the medical team assess them as medically fit to go home and any appropriate support has been put in place. As a carer, it is your choice to provide care and support, and you should not be pressured into providing care you are unable or unwilling to provide.
Five steps to successful hospital discharge
Step 1: Information
If the person you care for goes into hospital, the hospital should involve you and keep you informed as much as possible. Ideally, staff should inform patients when they expect to discharge them within 48 hours of admission.
Step 2: NHS Continuing Healthcare
NHS Continuing Healthcare (CHC) is care arranged and funded by the NHS for people with complex ongoing health care needs after leaving hospital. Unlike social care arranged via the council, it is free and not means-tested. You may need to request a CHC assessment if one is not offered.
The majority of people with support needs will not receive CHC, and the application process can be complex. See our Health and Hospital Services factsheet or contact us on 020 8649 9339, option 1 for details on eligibility.
Step 3: Needs Assessment
If the patient may need support when they leave hospital, the ward should refer them to the hospital’s Adult Care Team for a Needs Assessment, with their consent. The team will assess what care and support may be needed to enable them to return home, or move into a residential setting if going home is not possible.
Step 4: Carer’s Assessment
As a carer, you should be offered a Carer’s Assessment before the patient is discharged. The assessment should look at your ability and willingness to start or continue being a carer once the patient leaves hospital. You are under no obligation to take up, increase or continue in a caring role, and hospital staff should not make assumptions or pressure you into doing so.
Step 5: Care plan and care package
If the patient is assessed as eligible for support, a care plan will be created, explaining how their care needs will be met, who will provide support, who to contact regarding the care package and when the plan will be reviewed. All care packages should be reviewed by a care manager/social worker within six weeks.
For people who only need some short-term support to regain their independence, reablement can provide support to help learn or re-learn daily living skills after leaving hospital. Support is free for up to six weeks, and will afterwards be charged for. In Croydon, reablement is provided by the Community Intermediate Care Service (020 8274 6444; www.croydonhealthservices.nhs.uk). Please note that these services may not be offered to people whose support needs are not likely to decrease after six weeks.
If you or the person you care for feel the care package is not adequate, try to resolve your concerns before leaving hospital. If the patient has already been discharged, contact Croydon Council on 020 8726 6500 and ask for a review. Bear in mind that this can be a lengthy process. Please note that if ongoing support is required after the reablement period, the person you care for will be financially assessed for their ability to pay for support.