The number of people being unsafely discharged from hospitals remains “unacceptably high as a result of political maladministration”, according to MPs.
Poor patient discharge can take the form of both delayed transfers of care and premature or early discharge, noted the Common’s public administration and constitutional affairs committee.
“Hospital staff seem to feel pressured to discharge patients before it is safe to do so”
The committee’s latest report, published today, criticised the historic structural split between health and social care services that meant they were being managed and funded separately.
The committee called on the government to set out, by March 2017, arrangements for “long-term, sufficient, sustainable and integrated funding for adult social care”.
It also recommended the government set out a clear plan for implementing integrated health and social care plans across the country.
The report reviewed work already carried out by the Parliamentary and Health Service Ombudsman, which highlighted harrowing cases that illustrated the human costs of poor discharge, causing suffering and distress for patients, and anguish for their carers and relatives.
However, the committee said it found that the discharge failures identified by the PHSO report were “not isolated incidents but rather examples of problems that patients, relatives and carers are experiencing more widely”.
“We see too many cases where discharge from hospital has gone horribly wrong”
Despite increased attention to the issue, unsafe discharge remained a “persistent problem”, it said. The committee called for more data to be gathered on the scale and impact of discharge failures.
It also noted that, while “excellent” guidance on best discharge practice was available, the extent to which good practice was implemented “varies across the country”.
Barriers to the implementation of best practice were “prevalent both within hospitals and at the interface between health and social care”, said the committee. Pressures on resources and capacity within hospitals were leading to “worrying and unsafe discharge practices”, it added.
The committee called on health and social care leaders to ensure that staff were ”operating in a culture where person-centred care is the undisputed priority”.
Committee chair Bernard Jenkin, Conservative MP for Harwich and North Essex, said: “Hospital staff seem to feel pressured to discharge patients before it is safe to do so.
Unsafe discharge levels remain ‘unacceptably high’
“Hospital leadership must reassure their staff that organisational pressures never take priority over person-centred care,” he said. ”And staff need to feel a level of trust and openness that enables them to raise concerns about unsafe discharge.”
Health service ombudsman Julie Mellor said: “We see too many cases where discharge from hospital has gone horribly wrong, particularly for older, frail people who often don’t have the right support in place at home to cope on their own.
“These shocking failures will continue to happen unless the government tackles the heart of the problem – the chronic underfunding of social care which is pilling excruciating pressure on the NHS, leaving vulnerable patients without a lifeline,” she said.
Izzi Seccombe, chair of the Local Government Association’s community wellbeing board, said councils were “doing all they can to avoid” patients being unsafely discharged from hospital but added the NHS was in “real danger of collapse” if social care services do not receive adequate funding.
“Getting people out of hospital more quickly and back living at home will only work properly if councils get enough resource throughout the whole year to fund adequate provision of care services,” she said.
She reiterated calls for £700m funding earmarked for social care through the Better Care Fund by the end of the decade to be brought forward.
How often do you witness "poor patient discharge"? (Ie delayed transfers of care and premature or early discharge)