Of course there will always be times when it is what the patient wants, but there are also too many worrying cases of elderly and vulnerable patients who are leaving hospital in the dark, and without the support they need to return to their lives in the community.
Hospital discharge and a patient’s wellbeing in the first few days and weeks once they return home is an often overlooked part of their journey through the health system, but it is actually one of the most crucial aspects of their care. If it is done properly, with discharge teams working in partnership with well-designed community-based services that address patients’ practical and emotional needs, then there is a much better chance of recovery. But when it is ignored or poorly delivered, patients’ fragile recovery is put at risk, and the strain on local medical services increases, with many patients – particularly the elderly – over-relying on GPs, as the RCGP has warned.
At the British Red Cross we know first hand the importance of post-discharge community programmes, because our health and social care staff and volunteers help thousands of people to live independently every day. By intervening at a potential crisis point we not only improve individuals’ wellbeing, confidence and resilience, but also reduce the burden on GPs and other local health services.
For example we recently helped an elderly gentleman who returned home to find his house had flooded, something that could have triggered another health breakdown for him without our support. Another time we helped a primary school teacher who returned home from gruelling cancer treatment to find it was the little things she couldn’t cope with – cooking, cleaning and bringing a sense of normality to her family.
And in Bristol the British Red Cross has recently started running an assisted discharge scheme in conjunction with the Royal Infirmary’s A&E department. This service provides transport home, practical help and companionship for patients, whatever time of day they are discharged, and then makes sure they are signposted to – and helped to engage with - the right services for them, another massively undervalued aspect of care.
But although many commissioners are now realising the importance of these services for both patients and budgets - in Nottinghamshire our community-based crisis intervention programme has saved local clinical commissioning groups hundreds of thousands of pounds, and drastically reduced avoidable hospital admissions – there is still not enough investment. In part this is because these schemes often fall in the gap between the worlds of healthcare and social care, and as such are often undervalued, underfunded, and overlooked. This needs to change. The practicalities of discharging patients and their care in the community must be recognised as a vital part of their journey back to health and wellbeing, otherwise hundreds of thousands of people will be denied their best chance of recovery, and GPs will continue to see their workload increase.
- Natasha Kutchinsky is public policy advisor for the British Red Cross.