What to consider ahead of a hospital discharge

Recent figures published by the Nuffield Trust show that the total number of patients in acute hospitals who were ready to leave hospital but were delayed in being discharged increased by 43% between June 2021 and September 2023. At its peak in January 2023, there were 14,710 patients delayed in hospital.

If you are admitted to an NHS hospital for emergency acute treatment, including if you lack capacity to make decisions about your care and treatment, there are complex laws and regulations governing NHS practice and the linked involvement from social care professionals in the relevant local authority. These apply particularly at the point of discharge from hospital, regardless of whether you routinely use NHS services or have the benefit of private medical treatment. The rules and processes can often seem impenetrable and there are also complex issues of NHS and/or social care funding to consider for some.

If well advised, most people ensure that they have prepared a will and a Lasting Power of Attorney for health and welfare and property and financial affairs (LPA). Some have also prepared advanced decisions to refuse life-sustaining treatment (a ‘living will’ or ‘advanced directive’). What many have not done, is to consider how and where they would like to receive care and support, should there come a time when that is needed, particularly after inpatient hospital treatment.

Patient discharge and lack of capacity

Unfortunately, patients who are being discharged from hospital may be unable to communicate their wishes and feelings about this important decision at the stage at which any such decision needs to be made. There may be a sense of urgency in making the decision which does not allow them the time to give it the thought and planning that they would usually want.

Giving thought, in advance, to how and where you would like to be cared for, if you are temporarily or permanently unable to live as you currently do, is important.

It is also important to speak about your plans with your loved ones and, of course, any attorney appointed under a LPA. If such consideration and discussions happen in advance, it can significantly speed up and simplify the hospital discharge process.

Many questions about exactly what you will need, and how those needs can be met, will of course be impossible to answer in advance, but you could, for example, consider:

• If your home will be suitable for you if you have mobility and/or nursing needs?
  • Is there an accessible bathroom?
  • Are the doors, hallways and corridors wheelchair accessible?
  • Is there sufficient space for a live in carer if needed?
• Would you like to consider any specific residential and/or nursing homes
  • What sort of placement would you want?
  • Where would you want to be based?

Many are faced with making these important decisions urgently and unexpectedly, after an accident or injury results in an unexpected admission to hospital. It is advisable to take some time to give these issues some thought in advance.

If you need any assistance, advice or guidance before or after you or a family member has been admitted to or discharged from hospital, please contact Zena Bolwig.