Major changes vital for patients leaving hospital, says Healthwatch Staffordshire

STAFFORDSHIRE’S three main hospitals are taking action to improve the way they discharge patients after the county’s Health watchdog highlighted issues at each site.

Royal Stoke University Hospital, County Hospital in Stafford and Queens Hospital in Burton were all subject to a review by Healthwatch Staffordshire after patients, their relatives and care home providers criticised the poor experience of using Discharge Lounges.

Discharge Lounges are used by hospitals as a holding area to free up beds on wards while patients are waiting for medication or transport home.

Enter and View volunteers working for Healthwatch Staffordshire collated evidence over three months, last year, and the findings of their review have been highlighted at national level in a Healthwatch England report* released today, Thursday.

The volunteers spoke to patients, carers and staff in each Discharge Lounge and found:
Serious delays at all three sites in obtaining medication to take home, and some patients being moved from the ward to the discharge lounge even before a prescription had been written.
Long delays in securing transport home which cannot be arranged until a prescription has been delivered. This often results in a delay of a further two hours, having a ‘detrimental effect on a patient’s wellbeing’.
A small number of patients who appeared too ill and confused to be cared for in the lounge spending long periods waiting.
Poor signposting making it difficult for relatives to find the sites and no pick up points which contributed to further delays in discharge for patients as relatives needed to find parking.
Cramped conditions at all three sites.
Apparently a lack of criteria about when discharge lounges can be used instead of discharging patients directly from the ward, and pressure on staff to use the lounge for ‘bed-freeing’ without full regard for a patient’s welfare.
An area for praise in all three cases was the commitment of staff, with the report stating: “All staff…presented as committed, enthusiastic and dedicated to making the patient experience as comfortable as possible”.

Healthwatch Staffordshire Executive Chairman Robin Morrison

Staff who were interviewed for the report, however, highlighted that they sometimes felt some patients were inappropriately sent to the lounge, despite their concerns.

Following the Enter and View visits, recommendations for improvement were sent to the three hospitals urging them to:
Consult with staff to improve the service
Create a clear criteria for suitable patient admissions
Provide leaflets to patients and relatives explaining about the Discharge Lounge and the service they can expect to receive (a practice already in place at Royal Stoke University Hospital)
Improve pharmacy cover to keep waiting times to a minimum, with a full audit of the current pharmacy service and processes advised
Fully analyse the requirements of a Discharge Lounge, taking all environmental factors into account, as well as the comfort and wellbeing of patients.

Healthwatch Staffordshire Executive Chairman Robin Morrison said:

“The issue of Discharge Lounges was a common theme for concern to Healthwatch, so our Enter and View volunteers set out to review the issues and make recommendations for improvement to the hospitals.

“Our aim is to ensure patients, carers and hospital staff are given a clear voice when care is not deemed adequate, and that hospitals are held accountable. Only by examining the problem and making recommendations for best practice across all three hospitals can progress be made.

“All patients are entitled to the highest quality of care from start to finish and the Discharge Lounge must be seen as an integral part of that patient experience.

“Patients in Staffordshire are clearly not alone in their experience and similar issues have been reported nationally in today’s Healthwatch England report*.

“We are delighted that all three Staffordshire hospitals are working to improve the patient experience and taking on board our recommendations. We will continue to monitor progress”.

Director of Nursing, Quality and Safety at University Hospitals of North Midlands NHS Trust, Trish Rowson, responsible for Royal Stoke University Hospital and County Hospital, Stafford, said: “UHNM NHS Trust has developed a strong working partnership with Healthwatch Staffordshire, who provide invaluable support by listening to our patients and sharing their views, feedback and concerns in an independent, structured way. This relationship helps us to ensure our improvement programme is truly patient focused and the Trust recognises that this is key to offering assurance to our local community, patients and commissioners.

“We would like to thank Healthwatch for this most recent study, which looked at the experience of our patients who were discharged from hospital via a discharge lounge. An improvement plan was written as a result of the report with a specific focus on improving patient awareness and patient comfort.

“Discharge Lounge patient information leaflets have been designed and staff have clear operational guidelines which specify those patients who are unsuitable for transfer to the lounge to support the smooth flow from ward to home. Whilst this works extremely well the majority of the time there are always exceptions out of our control when the Trust is under extreme pressure for beds. To minimise the impact on patients who may need to stay for longer periods than expected our discharge lounges provide a comfortable environment for all patients to wait. Meals, refreshments and snacks are provided. Patients can be accommodated on beds, recliners or chairs with radio, TV and magazines available to help pass the time.”

Chief Nurse at Queens Hospital, Burton, Paula Gardner said:

“The medical division have noted the comments and we are in the process of looking at the location of the lounge. This report will also go through to our Patients Experience Group.”

 

The full Healthwatch Staffordshire Hospital Discharge Report is attached, or you can download it at

http://healthwatchstaffordshire.co.uk/download/hospital-discharge-report/

To read the individual hospital Enter and View reports visit:
http://healthwatchstaffordshire.co.uk/download/discharge-lounge-stoke/
http://healthwatchstaffordshire.co.uk/download/discharge-lounge-county-hospital/
http://healthwatchstaffordshire.co.uk/download/queens-burton-discharge-lounge/