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

This has happened to me with both my births, it's one of the reasons I've decided to have a home birth with my third!! It baffles me too, especially when there's always a shortage of beds

For my last birth we had a lovely birthing suite with a pool etc. I was told we would go home at 3pm, paperwork didn't come through till 8pm after shift changes etc. We weren't moved to a ward because we were going home. So that birthing suite was out of action for an extra 5 hours due to paperwork delays. No meds needed, all we were told at discharge was to come back in a day or so for the pedication review. We were just hanging around waiting.

I felt really awkward sitting in a hospital bed for two hours after being discharged. In the end, I got up and left. It's not a prison.

It's not a prison no leave at your own free will but the point is that discharge prep can be quite important, we are working behind the scenes so it's better to try to u see stand the process and be patient so it all gets sorted properly.

But from experience, this is never properly communicated

It's all smiles and 'great, okay, you can go home now :)' and the nurse accompanying or coming over next for something confirms what the doctor has just said on ward round

But it's never let on that actually, you will be here for another day potentially until it's sorted

I was actually offered to stay another night once because of paperwork. No medicines to take away. I walked out and had to sign a form for it

Felt awful but it was just silly

I appreciate that but there are limits to how long people can reasonably be expected to wait for that to all get done. Unfortunately when you're sat on a hospital bed, often post operation still feeling poorly but knowing at some point that day you are going to have to move and wanting to get it over with and knowing it is horrendously under resourced in the hospital and no one has time to discharge you, then eventually there's little choice but to walk out.

In my case, I couldn't even get a nurse to respond to a buzzer and was left without pain relief or water for 5 hours after an operation. I wanted to go home because it meant I could keep pain relief and water within reach. I'm not going to stick around in pain in order that someone can fill in some paperwork.

Another big waste of resources is hospital transport. I was chatting to a hospital transport driver who was taking me to a specialised hospital 40 miles away (Was two hours late and couldn't be seen, but that's another story). He was telling me that at our local hospital, there is one block that is the other side of the road to the main hospital building. The porters are not allowed to push patients across the road, so hospital transport get called. There is local hospital transport, but they finish work at 8pm. If a patient needs to be taken across the (small) road after 8pm, hospital transport are called and they send someone from the big city hospital 40 miles away just to transport the patient across the road. Total madness.

Yes but that's confusing poor care with expectations over discharge. We have started saying now we will likely let you home later but we have to chase bloods/ finish rounds/ monitor you a few hours/ prescribe meds and then pharmacy gave to prepare them which is the majority of the work.

Just because we as Drs declare a patient fit for discharge doesn't mean pharmacy can do the meds immediately it takes a little time.

In an ideal world you wouldn't have to wait for a discharge letter or any medication. Just put both on the NHS app and you get any needed advice and can pop to any pharmacist once they tell you your prescription is ready.

Not really as it's dispensed according to the needs of the admission so communication and prep has to take place

Again though, you need to safe you won't be going soon then. It's not 'a little time'

Loads of posters here including myself have given examples of over 6/8 hour waits

It's not reasonable. It's not the doctors fault. Not saying that. But something really isn't right

Because the NHS is chronically understaffed and disorganised and the stressed junior doctor who has to do the summary has two million other jobs on their list, yours being the least urgent.

So short sighted.

Each Trust could employ a discharge manager who sorts the various paperwork and gets that person out of there.

I mean, I'm sure they do but unlike the billions of other NHS problems, this one, being to do with communication mainly, would actually be solvable.

I'm in Sweden and was in hospital recently. Here the dr gave me all the discharge paperwork when she did her Friday rounds. But that was just the medical discharge. She explained that I could go when I wanted but stay until I felt well enough. She expected me to be there for another couple of nights. Like hell. I was like a greyhound out of the trap.

Oh yes we have discharge liaison staff for that reason. Doesn't solve the dr workload issue.

This. Sick patients first. Rounds first. Doing ten things at once. Checking stuff for the discharge.
You can reply as many bed managers and discharge liaison as you like but if only the Drs can do the clinical stuff it's got to wait until
Either enough people or enough time

A genuine question: if dr sees patient, decides patient is medically fit to leave, then cant they just tap a button to update record and allow patient to either go home? Or to go to discharge lounge whilst they wait pharmacy? Have a quiet area with reclining chairs in discharge lounge.

Discharge summary needs to be written by a dr. It's the only info the gp gets about the admission.

I get what you're saying, everything you're saying makes all the sense... sadly this is not mine or many patients experience, it should be, you're absolutely correct I just wish it was like this here in the HSE

I waited for my discharge letter, for my GP. I subsequently learned that they had also sent it electronically. Madness.

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

Yes it does. The reason why is because due to popular demand the NHS ‘paper pushers’ were largely sacked because the NHS was viewed as ‘bloated’ and the money should be used to hire more front line nurses and doctors. But all that admin and paperwork still needed to be done, and guess who has to do it now? The nurses and doctors have to fit it in sideways while doing their primary job of saving lives.

The cost cutting of the NHS in the name of “efficiency” has made it less efficient. And cost lives. Patients sent home with poorly written discharge letters and the wrong guidance….ie someone with appendicitis given a flu leaflet and then dying when their appendix burst at home.

That would be my idea of hell. Having to put up with a TV blaring out would overload my senses and being in a chair for hours would probably exacerbate my pain.

I agree, it's a nightmare. Worse still is when you're good to be discharged but waiting for drugs to take home. Our (huge, London) local hospital is the size of a small, Dorset town and the pharmacist goes out with drugs to deliver at 9am and often doesn't make it back to the pharmacy for five or six hours. Meanwhile you've been told you can go, you may even have your discharge letter, but you're waiting for the pharmacist and his trolley. The first time this happened I asked if the pharmacist had a phone or radio so some could contact him, see where he was and I could go and get my drugs from him. I was told I couldn't do this. So I continued to sit. For hours and hours. Until he arrived. Taking up a bed the whole time. Absolutely ridiculous.

I discharged myself after my emergency c section. Large inner city hospital. Stayed there one night it was totally impossible to sleep with all the nurses chit chattering and the babies wailing. They wouldn’t give me pain meds at regular intervals. And told me off for pressing the button for help even though I was paralysed from waist down at that point. And shouted at another poor woman for not bringing any bottles when her milk wasn’t coming down. So as soon as I could walk again I told them I was leaving they said you can’t -it isn’t time- and you don’t have your discharge letter.
I said watch me. And left. No discharge letter.

If Dd is ever having a child I will pay for her to go private. No question.
My experience of NHS child birth was so traumatic I stopped at one child.