Why do the NHS do this? Big waste of time and resources surely

[treatsortreating]

I've had a few unlucky times in the last year. And a few before that

Literally every time (I have 3 fairly local
Hospitals). They all do the same thing

Ward round, doctor says you can be discharged, you're good to go.

But you're waiting HOURS for a discharge letter? 8 hours on from being told I was okay to go home. Buzzed nurse again. This time someone else as hand over had been done. 'Oh yes you can go, but we're just waiting on your discharge letter'

I don't understand it? I really don't.

Why don't they post it? It can be done. My DC has a serious issue with something and a very good yet a bit further away hospital always see her. I take her to them as they're great (Addenbrooke's, Cambridge)

They never discharge her and then make us wait for discharge papers. Those get posted. Simple.

Surely this method of making people wait for discharge letters is taking up beds? Someone could've had my bed over 8 hours ago and still I was waiting

I was still unwell so couldn't put up much of a protest but it just seems an insane waste of time

Totally agree. Just one of the many ways that the NHS needlessly wastes resources.

Discharge yourself. Just walk out, that's what I had to do once. Tell them you are going home whether they like it or not, and they can phone you when the discharge letter is ready to be collected.

I never even thought of this, but after I gave birth I said I was going home next day in the morning, but waited 8 hours for a discharge letter and some tablets!

I did this after spending a pointless further 12 hours in a maternity ward waiting on discharge papers

I self discharged and felt criminal. I had a safeguarding midwife phone me the next day to see if I was okay I was really polite about it but just insisted on leaving, I was clinically well and just waiting on paper work!

No backstory. I simply discharged myself.

It's all very odd.

I feel too awful doing that now. Like I'm a bit of a loose cannon if I do. So I don't. Argh

I once waited all day for the physio to come and see me to give me some exercises to do at home. She literally printed out a sheet of paper and then I had to wait for my medications to be sent to the ward. They wanted my bed so I had to sit in a chair for hours and I wasn’t at all well. It’s all so blooming inefficient and frustrating. I suppose you could just go home and ask them to send the letter on. Mine would be in MyCare so I wouldn’t need a paper copy but they expect you to give a copy to your GP, which I’ve completely forgotten to do that in the past. I’ve never been well enough to get it them within a reasonable time frame in any case.

Typical bureaucracy. Endemic to big orgs - the private sector can be almost as bad as gov.

But unless you need something like a cannula removing, or you're at a psychiatric facility, you can just leave.

Probably shouldn't, but I always take my own cannula out. Just unpick the sticky stuff, quickly and carefully remove it and then pop a clean tissue over the top. Never had any issues

Saves time otherwise that's another thing you'd be waiting on! And the nurses, who genuinely are very busy, forget as it isn't priority, and you feel guilty for buzzing again for it, so you can leave

It's all just a bit of a mismanaged nightmare

My local hospital has a great system. Once you're told you're going home you pack up & a porter takes you to a discharge ward. Basically a big day room. There's a TV, you can get tea, coffee & sandwiches & wait for your letter & any meds. It also has an exit right out to a restricted parking area which means whoever is collecting you is parked right at the door

It's a brilliant system.

PS: And when the hospital is understaffed, what do you think takes priority: paperwork for someone who is safe and well, or treating the next sick patient?

And the hospital is always understaffed.

Lister Hospital have this (Herts). My mum waiting over 6 hours for her discharge papers and meds. In a chair. She said it wasn't pleasant as she just wanted to go home and sleep

Not wait 6 hours in chairs. So I suppose it must depend how long their turn over is for getting meds ready etc

Of course. So you'd think they'd just post it? Like some hospitals evidently do because I've seen it

On a medical ward, the ward round is likely to go on until midday if not later. Then the urgent clinical jobs need to get done, plus at some point the staff like to eat lunch.

Then the discharge letter gets written, and sent down to pharmacy. Where it’s checked by a pharmacist. Dispensed by a tech, and then rechecked by a separate pharmacist before being sent back up to the ward.

But the only quicker alternative would be to take someone completely away from ward round and clinical jobs to sit in an office and write discharge letters. Which leaves the medical team short of people dealing with actual medical problems.

The longest I had to wait was about 90 mins & that was because of a mix up in my meds. The other occasions by the time I've phoned whoever is picking me up & had a coffee I'm pretty much ready to go.

They certainly seem to have the system working the way it should - which is surprising

I don't understand why they think it's sensible to give someone who might be still quite unwell a piece of paper for them to deliver to their gp. Just post it, or do you know, I've heard of this great system. It's only been in common use for about 30 years, called email. That could save a bob or two.

You'd think by now they'd be able to send a discharge summary electronically to your GP surgery.

There have been a few times where I've got so fed up waiting that I've just stood up and left.

Even longer wait if you need meds to take home. Having been in this position before I would just leave now and get someone to go back to pick up my meds when they were finally ready.

My dad waited hours to be discharged from Addenbrookes twice last summer.
The discharge letters are on MyChart anyway, so paper copies aren't needed. He wasn't waiting for meds. No reason why he couldn't just go.
It did seem to be very inefficient.

It’s quite common for patient to be discharged home if relatives are able to come back later to collect the prescription.
If not, the patient needs to wait for the meds.
If it’s just a letter then of course that can be sent after discharge and the GP gets an e copy anyway.

Maybe it varies from trust to trust .

You are not a prisoner, you can just tell them you are leaving and walk out (if you are not waiting for meds)

I’m a doctor. We’re usually very busy with other urgent tasks. The patient in the next bay over who you can’t see you might be sick and need an urgent CT scan. I might need to check their bloods to check their kidneys are doing ok and it’s safe to give IV contrast. I need to speak to the radiologist on call to get them to vet the scan.

Bed 7s family want an update as Mary might be started on end of life care today. Maybe I’m on call and also holding a cardiac arrest bleep and I’m called to an emergency.

Ultimately I must finish ward round so that I can figure out if any of my many other patients need urgent things doing. Ideally I’ll peel off and do your discharge letter quickly. For long stayers their letters can take over an hour. Once I do the medication pharmacy must check the medication. Perhaps you’re on an unusual med and maybe I need to call a specialist, maybe the pharmacist says actually there’s a shortage of this med we need to change it.

Basically we’re all just really really busy and short staffed, it’s not that we’re stupidly inefficient and haven’t realised we need to free up beds. We try to prioritise discharges when we can but that’s not always possible. It’s not patients waiting for letters and meds who are the issue, it’s patients waiting 9 weeks for a suitable nursing home placement.

same here with the HSE... my god the waste of a bed, the waste of my time & letters getting sent out a year before your appointment with no reminder closer to the time & they wonder why up to 30,000 appointments are missed yearly, can it not all be digitised? Christ my auntie gets text alerts for when Sam is ready to be wormed or whatever, it makes no sense at all... our schools have gone totally digitised, all non uniform days, sports days, half days, holidays & return days... even our school trips are paid online, it's beyond ridiculous!

Lol this is hilarious. You do realise you need doctors and pharmacists to do discharge letters? And we’re not being inefficient or sat lazing around. We’re busy doing more urgent jobs for sick patients. The issue is the lack of staff. Plenty of doctors are now scared of unemployment. We have enough staff but the nhs cannot afford to recruit.

@Medstudent12 I don't think anyone is blaming the staff, I've never had any problems with any medical professional but it's the bureaucracy... in this day & age there has to be better ways

It’s lack of staff and inefficient management/processes, not the doctors’ fault. Presumably more doctors and electronic letters sent to GP would speed things up? Then there are the ridiculous waits for meds, because hospitals never employ enough pharmacists to be able to deliver a reasonably timely service.

Absolutely. Not sure why you think it's hilarious that the NHS wastes resources. I have a disabled child so am in the hospital a lot and can tell you a hundred ways that I've seen with my own eyes that the NHS wastes resources. The staff are frustrated too at the inefficiency.

No one is blaming individual doctors or saying that they're not busy. It's the systems and processes that are inefficient.