Patients failed after poor hospital discharge planning

Death or suffering could have been prevented if hospitals carried our right checks, says report

Patients should not be discharged from hospital if they are not fit to leave, says the health service ombudsman.

In a damning report published today (May 11), the parliamentary and health service ombudsman describes a 36% increase in discharge-related incidents that led to an investigation.

Death or suffering could have been prevented if hospitals carried out the right checks, the ombudsman Dame Julie Mellor said.

A total of 221 complaints about hospital discharge were investigated in 2014-15, an increase of a third on the previous year.

The report highlights nine of the most serious cases the ombudsman has investigated to highlight the gap between good practice and patient experience. It reveals how one woman in her 80s was discharged from hospital to an empty house, in a confused state with a catheter still in place.

An older man with dementia was left on a locked psychiatric ward for nine months following disagreements about discharge between the hospital and local authority.

Four main areas of concern flagged up in the report are: patients being discharged before they are ready to leave hospital; patients not being assessed or consulted properly before discharge; relatives and carers not being informed of discharge; and patients being discharged with no home care plan in place or being kept in hospital due to poor coordination across services.

The report points out best practice guidance which includes involving patients and carers at all stages of planning, and starting discharge and transfer planning before or on admission to hospital.

Dame Julie said: ‘Poor planning, co-ordination and communication between hospital staff and between health and social care services are failing patients, compromising their safety and dignity.

‘Health and social care leaders must work harder to uncover why ten years of guidance to prevent unsafe discharge is not being followed, causing misery and distress for patients, families and carers.’

Age UK charity director Caroline Abrahams said the report marked ‘a new low’ and called for greater investment in the NHS.

RCN professional lead for acute, emergency and critical care, Anna Crossley, said: ‘Nursing staff are dedicated to providing high quality, safe patient care, but sometimes circumstances prevent this from happening consistently. 

'Discharge planning is only possible with the right workforce in the right place, and with the ability to deliver services across the whole health and social care system.’

An NHS Improvement spokesperson said: 'Better discharge processes, such as those being worked on by NHS Improvement’s emergency care improvement programme to support local health systems to make improvements, will result in vulnerable patients being protected while reducing potentially harmful delays in appropriately discharging those who are medically fit.’

To read the report click here