Hospital

Hospital discharge is now governed by legislation in the Care Act – Schedule 3 and a set of regulations called the Care and Support (Discharge of Hospital Patients) Regulations 2014.  Covid led the government to issue two versions of a new approach to hospital discharge however, March and August 2020.

No NHS professional is in a position to determine whether it is safe for a person to go home unless they know all the circumstances – including a firm idea of the actual budget that the council’s panel or other decision maker has approved of spending, for meeting the assessed needs of the specific person. The vast majority of findings of fault in this regard arise from Councils failing to carry out assessments. This may be after a patient is discharged, or maybe before discharge, resulting in a prolonged stay in hospital. This area of maladministration shows how hopeless it is to expect two different organisations with different agendas to integrate or even work in partnership together.

Hospital registrars and clinicians often maintain that someone is not ‘safe’ to go home, but without any idea of what is or is not waiting for them at home, what the environment is like, in terms of risk, or the lowest practicable amount of care that would need to be made available if the council were to do a lawful, rational, transparent, professional assessment of what was needed. Instead, very often, council staff on the hospital discharge team will simply say “We only do three visits a day” or “You can only have £575 a week, because that’s the cost of residential care” regardless of the ability or willingness of a family network to reduce the cost differential if the relative were to be cared for at home, the Mental Capacity Act, the wishes and feelings of the person in question, the duty to promote well-being, specifically including emotional and psychological wellbeing etc.

Name of CouncilSubcategoryTitle of ReportNumber
BirminghamEAB/DischargeBirmingham Council at fault in charging for ‘Interim bed’ when a person was eligible for free Enhanced Assessment Bed (EAB)19 004 245
Windsor and MaidenheadDischargeRoyal Borough of Windsor and Maidenhead at fault for failing to properly consider the risks when separating a married couple of 59 years, failing to provide adequate care and failing to provide appropriate complaint responses18 015 872
EnfieldDischargeEnfield Council at fault for failing to inform a person’s family of his discharge from hospital and failing adequately to consult with them about care home options and fees 18 007 704
CroydonDischargeLondon Borough of Croydon and NHS Trust at fault for delaying assessments and referrals, and allocating unsuitable accommodation18 005 311
HaringeyDischargeHaringey Council at fault for avoidable delays in assessing needs for an elderly woman waiting to be discharged from hospital 17 016 601
HillingdonDischargeLondon Borough of Hillingdon Council at fault for failing properly to explore options and reassure themselves of the consent of a service user to a hospital discharge care package decision 18 018 812
Kent CountyDischargeKent County Council at fault for failing to carry out assessment before a person was discharged from rehabilitation unit 18 016 867
Suffolk County CouncilDischargeSuffolk County Council and Trust at fault for failure to complete a CHC checklist and failure to discuss discharge planning with family members18 014 942
Surrey CountyDischargeSurrey Council at fault in handling of safeguarding procedure and failing to intervene when a care home refused a patient’s return 18 012 625
HertfordshireDischargeHertfordshire County Council found at fault for delegating responsibilities to Foundation Trust and ultimately for allowing it to fail to ensure sufficient assessment and discharge planning17 013 954