Patients in Wiltshire who have broken their hips have given their views on a service which supports them to return home as soon as they are medically fit.

The therapy team at Salisbury NHS Foundation Trust has developed an Early Supported Discharge (ESD) service, which helps patients with a fractured neck of femur (broken hip) be discharged from hospital earlier and allows rehabilitation at home through person-centred care.

Healthwatch Wiltshire was approached by the therapy team to gather feedback from patients and their families on the service. Volunteers and staff led focus groups with patients and their unpaid carers to find out their views on the service. Key findings included:

  • Nearly all patients said that they wanted to be supported to go home from hospital as soon as possible.
  • The support received from the ESD team enabled patients to return home quickly.
  • People were very happy with the quantity and quality of support provided by the ESD team and its approach.
  • Some said it was not always clear about the specific role of the team in supporting early discharge.
  • Others felt some elements of the discharge process could be improved, e.g. getting medication.

One relative told Healthwatch Wiltshire: “All the ESD team we came into contact with were professional, sympathetic to our concerns and extremely helpful.  Because the care package could not be put in place for several days the ESD team would attend my mother each morning.  This was so good and such a boost to her confidence and ours as we could ask about any worries we had.

“They always showed kindness and it meant Mum could get home (which she was keen to do) earlier than if she had to wait for the care package to start.  Also aids were arranged efficiently.  All in all – excellent!”

A patient shared during the feedback: “There was lots of preparation for my return home while I was in hospital – crutches, raised loo seat, a percher, high seated chair, and arrangements for a grab rail to be fitted beside the shower.  This was all excellent.”

Another said: ““All members of staff were extremely helpful to ensure smooth transition to home life.  Home follow up visits were helpful.  They went that extra yard.”

Although the majority of the comments were very positive, a few negative responses related to waiting for equipment, lack of support with shopping and personal care and difficulties getting to the doctor’s surgery on public transport.  Others were concerned about the difficulties faced for those without family support.  One patient said: “Early discharge is fine if you have family who can help you get to the doctors when needed. If not, it is hard work on public transport as there is no help if you are on your own.”

Lucie Woodruff, Healthwatch Wiltshire manager said: “From the patient’s perspective the ESD team appears to be working well and offering high quality support.  Patients and their families have given great feedback which we have fed back to the team as recommendations to further enhance the discharge process.”

The report, with recommendations to help improve the service from the patient perspective, has now been shared with the therapy team at Salisbury NHS Foundation Hospital Trust.

Emily Scotney, from the therapy team, said: “We are extremely grateful to Healthwatch Wiltshire and to our patients and relatives for all their support and feedback in generating this report.  It is a valuable resource in understanding how patients have experienced our service which is extremely important when setting up new services.

“Within the ESD team we strive to remain flexible and to ensure that the service meets the needs of the patients, and is shaped by their needs as opposed to what we offer being dictated by what is available.  We strive to go the extra mile for our patients – whether that is taking them shopping on their way home to ensure that they are confident in returning to doing this independently, or teaching them to use online shopping to help them maintain their independence.

“Each patient is an individual with different needs and things that matter to them, and we strive to reflect this in the service that we offer.  In order to ensure that this quality and flexibility continues, this report has highlighted to us that some aspects of the service need enhancing – particularly around communication.

“We hope to be able to work alongside our patients in developing communication strategies to support the discharge process that will boost their confidence, and that of relatives and carers, and improve their experience of leaving hospital.”

Read the full report: Better Care Plan engagement report: an evaluation of Salisbury NHS Foundation Trust Early Supported Discharge Service for patients with fractured neck of femur

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