Your care shouldn’t end the minute you leave hospital. A ‘discharge plan’ helps older people transition from hospital to home or residential care.
During the coronavirus pandemic, there were reports of older people in hospital being discharged into care homes without being tested for COVID-19. It’s believed that this was a major contributor to the crisis in care homes. Now the government has announced extra funds to ensure people can be safely discharged from hospital into the most appropriate setting and with the support they need.
From 1 September, the NHS can access £588m to provide up to six weeks of additional support for people leaving hospital. This funding is expected to pay for home care, community nursing, residential care or services such as physiotherapy.
People were already entitled to this support through a service called NHS Intermediate Care, but many found this was delayed or unavailable during lockdown. In order to free up beds during the coronavirus crisis, the organising of intermediate care took place after many patients were back in their own home.
Now hospitals are getting nearer to something resembling normality, Which? explores what older people with care needs can now expect when they’re discharged:
1. Questions about your support needs
Discharge planning should start as soon as possible and you (or your carer or relatives) should be informed at all stages. You should be given an expected date of discharge which will be reviewed regularly.
You might need extra support when you leave hospital. A hospital social worker should help establish whether that’s the case. They will ask you some questions, such as whether you can manage tasks such as climbing stairs, personal care routines and preparing meals. This will help them come up with a plan that outlines who will be involved with ongoing care once you leave hospital.
It should also include the details of who to contact for help and support once you’re back home.
- What you need to know about hospital discharge
2. Help with transport arrangements
You have the right to discharge yourself from hospital at any point, but we wouldn’t recommend leaving until your doctor is happy that you are well enough to go home and there’s a discharge plan in place. You want to be confident that you can manage safely at home.
But once you do have expected date of discharge (EDD), plan how you’re going to travel from the hospital. You’ll probably want to arrange for a family member to come and collect you. But if there’s no one who can help, healthcare staff should help you arrange appropriate transport.
3. A decision on temporary care
You may be entitled to up to six weeks of free care at home or in a residential care home. This is what the government has announced new funding for.
This service is called NHS Intermediate Care and is arranged by the hospital social work team before you’re discharged.
If you need care for longer than six weeks, you may have to start paying for it yourself.
4. Support if you have complex needs
Older people with complex health needs may be eligible for NHS Continuing Healthcare.
This is care which is fully funded by the NHS, for people who have a need for significant, ongoing health care outside of hospital. There isn’t a specific set of conditions that are covered by the scheme. Eligibility is based on the level and complexity of an individual’s health care needs and is decided after an assessment.
During the height of the pandemic, many assessments for this service were delayed. But the government says these will restart from September to ensure that people with health problems can continue to access the care they need for free.
5. A plan for a needs assessment
If you may require long-term social care once you return home but are not eligible for NHS Continuing Healthcare, you should get a needs assessment from your local authority. This assessment may take place before you leave hospital or, if there’s a temporary care plan in place, before the six weeks of the NHS Intermediate Care package is up.
6. COVID-19 precautions if you’re going to a care home
Care homes were badly affected during the peak of the pandemic. While transmission of COVID-19 is still a concern, extra precautions are in place for care home residents who have been in hospital. For starters, all current and new residents must have a coronavirus test before they return to or move into residential care.
After arriving at the care home, you must then undergo a 14-day period of isolation in your own room. This is to further reduce the risk of spreading coronavirus to staff and other residents.
- Read more about what care homes are doing to keep residents safe