‘Revolving door’ hospital discharge culture criticised after patient accounts

Dr Mike Smith, a GP who used to work at Ealing Hospital, vowed never to work there again because of the “significant harm” that is likely to come to a patient in the future.

Care United Kingdom said both the firm and doctor “refuted any suggestion patients have been discharged before treatment is complete”. In 2012-13 there were more than a million emergency readmissions within 30 days of discharge.

Nearly one in five patients re-admitted for the same problem are back in hospital within a week.

Another involved a young man with severe mental health problems who had been discharged with no consultation with his psychiatrist and no treatment.

The Safely Home report points out that similar systemic failings have been happening for decades, but “artificial boundaries” between managers, clinicians and care workers enable them all to dodge the blame.

The newly published report highlights more than 3,000 stories and pieces of evidence that reveal the cost of getting the discharge process wrong.

The government is proposing to build a database that would identify 18 million patients and store records of their GP appointments without their consent, according to documents obtained by the Guardian. One woman told of the how her husband was discharged after a suicide attempt, despite his repeated pleas to stay because he did not feel able to cope.

Further recommendations cover areas such as agreeing discharge plans with the service user, and giving service users clear information about all possible support options available to them after discharge or transfer of care.

In the report, Anna Bradley, chair of Healthwatch England, writes: “When people fall through the gaps between different parts of the health service or between health and social care, it causes a huge amount of suffering, and comes at a cost of billions to the taxpayer too”.

Healthwatch England said its report has uncovered a “number of common basic failings” including hospitals not routinely asking patients if they have anywhere to be discharged to, details of new medications not being passed on to Global Positioning System and carers, and families not being notified when loved ones leave hospital.

Basic communication failures between hospitals and community care providers were also noted, leading to patients dying in a place that was not their choice or without the level of support they required. “We hope that the increased focus on integration of health and social care, and pressure on finances will create a new impetus to fix it”.

“We have raised issues surrounding the various flows of patient information for purposes unconnected with their direct care with the Health and Social Care Information Centre and NHS England to ensure that any disclosures comply with the law”.

“The process can be confusing for older people and their families as they’re often asked to make complex and hard decisions when they’re already under considerable pressure”.

An NHS England spokesman said: “It is crucial not to misunderstand what is being proposed”.

‘With two-thirds of readmitted patients returning to hospital within a week, we need to start making changes now.’.

The probe into Health Secretary Jeremy Hunt’s NHS also revealed patients were given thermometers to take their temperature, to determine which were seen first.