Hospital discharge changes during Covid-19
In August 2020 the UK government promised a £588 million fund to cover adult social care or the immediate costs of care for people in their own home after discharge from hospital. Here’s a run-down on the latest guidance for those leaving hospital, their family and their carers. (If you click on the links for the UK.gov website statements, be aware that they seem to have been published in a variety of formats, including pdf and odp).
The government’s statement says that from 1 September, the NHS will be able to access the funding in order to provide up to 6 weeks of additional support so people can receive ongoing help with their recovery and rehabilitation after they leave hospital. This could include support in their home or access to services such as physiotherapy.
If you’d like to delve more deeply into the hospital discharge service that will be operating over the winter, it would be worth taking a look at Policy and Operating Model for the NHS.
Fast exit from hospital
The emphasis in all the advice is that patients should leave hospital as soon as possible, to free up beds for care of those affected by Covid-19. The government says it expects most people to be discharged back to their normal residences, but that a very small proportion will need or benefit from short- or long-term residential, nursing home or hospice care.
Discharging patients from hospital to a care home has been a controversial topic during the pandemic, with testing for coronavirus at the heart of the problem. While patients are now being tested before they are discharged, the results aren’t necessarily known until after they’ve arrived at the care home.
The latest advice states that ‘It remains the case that no one should be discharged from hospital directly to a care home without the involvement of the local authority, and that all patients are required to be tested prior to discharge to a care home. No care home should be forced to admit an existing or new resident who has tested positive for coronavirus if the home would be unable to cope with the impact of their illness.’
Advice to patients entering hospital
When people go into hospital for any length of stay they should be given a single-page hospital discharge information sheet. This introduces the idea that they will be discharged as quickly as possible, probably to their own home, but possibly into care.
The sheet emphasises that patients should be able to speak to staff about their post-discharge care plan, and that they can involve family and friends in the conversation – although the thought process here is to find out how family and friends can provide support once the patient is home.
Advice to patients leaving hospital to go home
The one-page leaflet that patients should be given explains that they do not have the choice to stay in hospital once their health care team has determined they no longer need hospital care. The team should discuss discharge and transport arrangements with them (and a family member, friend or carer if they wish).
If the patient needs more care than before they went into hospital, they are entitled to six weeks of free care to support their recovery. After that, they may be required to contribute to the cost of care. The leaflet should give details of a local team to contact after discharge.
Advice to family and friends
There’s another leaflet for family and friends of a patient who needs ongoing care at home after leaving hospital.
This is mostly about looking after yourself while you’re being a carer, and where you could go to get support, such as the Carers Trust and Carers UK.
There’s also a pointer to the government advice for unpaid carers during the coronavirus pandemic. This is a collection of advice you may already have seen about protecting the most vulnerable, hygiene, face masks, collecting prescriptions, calling on family as backup if you are unwell, or contacting local authorities for help.
Advice to patients going to another place of care
The leaflet for those going into a place of care rather than to their usual residence is essentially the same as that for going home, but explains that in this case the patient will be discharged with the care and support they need to a ‘bed in the community’. If the patient needs more care than when they went into hospital, again the six weeks of free care applies.
The advice adds that it’s possible the person may be moved more than once after discharge. ‘This is because we will be trying to find the best place for your ongoing care.’ Questions are referred to the local team, contact details for which should be on the leaflet.
NHS Continuing Healthcare (NHS CHC) assessments will also restart from September 2020. For more detail on this, take a look at the guidance on the reintroduction of NHS CHC.
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