Problems with hospital discharges in England, highlighted in the largest annual patient survey, reinforce the need for greater integration between health and social care, the sector regulator has said.
The Care Quality Commission inpatient survey found that a majority of patients were positive about their hospital care but a significant minority experienced problems on discharge.
A third of respondents who were frail said the care and support they expected when they left hospital was not available when they needed it. Three in 10 frail people said they had not had discussions with staff about the need for further health and social care services they might require post-discharge.
Four in 10 of all patients surveyed left hospital without printed or written information about what they should or should not do after discharge, and the same proportion said their discharge was delayed.
The relationship between health and social care has come under scrutiny during the coronavirus pandemic because of the discharge of 25,000 hospital patients to care homes between 17 March and 15 April before testing became routine. Critics have said the decisions protected hospitals at the expense of care homes, which have recorded a heavy death toll from Covid-19.
Prof Ted Baker, the chief inspector of hospitals, said: “The recent Covid-19 crisis has highlighted in very stark terms the interdependency of health and social care. While this survey was carried out before the pandemic spread to the UK, the results provide further evidence for the need for greater collaboration and demonstrate that where services are not integrated, this can have a detrimental impact on how people experience care.”
Just under 77,000 people aged 16 or over who had stayed in hospital for at least one night during July last year responded to the survey. Eight out of 10 said they had always been treated with dignity and respect during their hospital stay, and the same proportion said they always had trust and confidence in the doctors treating them. Nine out of 10 said they were always given enough privacy when being examined. Additionally, responses to questions about cleanliness, choice of food and hydration were overwhelmingly positive.
Baker said the results reflected “the significant efforts of healthcare professionals working tirelessly to provide care in hospitals across the country” but he expressed disappointment at problems experienced by patients leaving hospital.
Of the patients who said their discharge from hospital was delayed, nine in 10 said they waited for longer than an hour, and one in four said they were delayed for longer than four hours.
Among those given medication to take home, more than four in 10 said they were not told about the possible side effects.
“This year’s results indicate that people are facing longer discharge delays and reveal continued concerns around the quality of information provided when they are ready to return home,” Baker said. “It is particularly worrying that for people who self-report as being frail, the difficulties in accessing support after leaving hospital were even greater.”