Hospital patients to be told when they are going home almost as soon as they have arrived

The commitment is part of Lancashire Teaching Hospitals’ new “discharge charter” which requires everybody involved in an individual’s care to work towards a set date for them to return home.

“The aim is to create a clear pathway out of hospital...so that everything required - medication, transport, keys - is ready on the first day [a patient is] able to leave,” Emma Ince, from Greater Preston and Chorley and South Ribble Clinical Commissioning Groups, told a meeting of Lancashire County Council’s health scrutiny committee.

Every ward now has a member of staff responsible for smoothing the process of discharging patients and the charter pledges to provide a seven-day-a-week service “as far as possible”.

The new system has also seen the introduction in Central Lancashire of a so-called “home first” policy, under which patients’ future support needs are assessed once they have returned to where they live. The idea is to reduce unnecessary time spent in hospital and has been hailed a success after being trialed in the east of the county.

But several committee members wanted to be reassured that the new system was safe and did not lead to patients having to be readmitted.

“I get quite a lot of comments from ambulance staff who come to me and say, ‘Why did they let that individual out?’ - because they are clearly not well enough to be at home,” Eddie Pope told the meeting.

Members heard that just two patients had been readmitted since the discharge charter was introduced at the beginning of October - and that the going home date was not set in stone if circumstances changed during a patient’s stay.

“That date, if it needs to change for clinical reasons, will do so, “ Ailsa Brotherton, Director of Continuous Improvement at Lancashire Teaching Hospitals, said.

“We’ve worked with our consultants who have designed the definition of the 'expected date of discharge' and they are working with junior doctors, nurses and therapists to set the date.”

Labour group leader on Lancashire County Council, Azhar Ali, suggested that the discharge process could be sped up further if patients were allowed to collect some hospital prescriptions from their local chemist rather than the hospital pharmacy, where they may have to wait “six or seven hours”.

But Faith Button, Lancashire Teaching Hospitals’ Interim Director of Performance, said the trust had a responsibility to “make sure [patients] know what they are taking and how to take it”. Junior doctors are now charged with arranging medication between 12 and 24 hours in advance of a patient’s expected discharge date.

The meeting heard that it would probably not be possible to achieve zero discharge delays, because of the complexity of some cases.

THE CHARTER

Pledges include:

We will ensure that you and, with your permission, your family and carers are always included and listened to with regard to your care and discharge.

We will ensure that wherever possible assessment for longer term needs takes place outside of the hospital setting.

We will not undertake any tests that can be done outside of hospital when you are ready to leave hospital and have a plan of care in place.

We will keep you and your family and carers informed and involved with the estimated date of discharge on a daily basis and this will be visible next to your bed.

Health and social care partners will work together to ensure the planned discharge/ transfer requirements are supported and equipment needs are met.