ghp July 2015 | 27 public health Report from Healthwatch England shows that 2012 to 2013 there were over 1 million emergency readmissions within 30 days of discharge, costing the service an estimated £2.4 billion. The report indicated that the most vulnerable patients, such as the elderly, the homeless and those with mental health problems, were most at risk because of the health service’s poor discharge policy. Many of the 3,495 people surveyed in a recent YouGov report cited by the Healthwatch study were often left feeling adrift after leaving hospital, with 12% stating that they did not feel they were able to cope in their own home after being discharged from hospital and 24% saying they did not feel their friend or rela- tive was able to cope following their discharge. There was also a lack of support and information avail- able for these penitents with 14% telling the survey that they did not know who to contact for further help following treatment and 18% of people feeling that their friend or relative did not know who to contact. In addition to this 18% of people who have been discharged from hospital in the last three years did not feel they received all the social care support they required after leaving hospital and 26% feeling the same way about a friend or relative’s post discharge care. The issues were even evident prior to the patient’s discharge, with 21% of those surveyed declaring that they did not feel they were fully involved in decisions concerning hospital treatment and planning dis- charge, with a similar proportion, 22% feeling their friend or relative was not fully involved as an equal partner in their care and discharge. Participants in the Healthwatch England report defined several key reasons why their care was inad- equate, notably a chaotic atmosphere in the hospitals with many patients experiencing delays and a lack of co-ordination between different services. This lead to patients feeling left without the services and support they need after discharge. These issues are structural problems within the service which could be resolved with the application of more funding and greater communication links being established between different departments. However, there were also a number of issues identified by respondents to the survey which would require further training for staff, as well as instilling a greater atmosphere of respect throughout the service, as some of the patients who participated in the report stated that they felt stigmatised and dis- criminated against and that they are not treated with appropriate respect because of their conditions and circumstances. Some also felt that their full range of needs is not considered. The report also discussed the issue with 120 NHS healthcare trusts, finding that almost all had a discharge checklist but less than half check whether people have a safe home/place to go when discharged, or whether there are necessities such as food, water and heating. The report also found that one in three trusts do not ensure notes about new medication are properly recorded and passed on to GPs or carers and one in ten do not routinely notify relatives and carers that someone has been discharged. However these issues were doubles created by the confusion caused by the fact that the report estab- lished that the trusts used a variety of guidance from around 57 different documents, highlighting the need for standardised discharge guidelines for NHS trusts which are regularly updated and provided to staff. Anecdotal evidence was collated within the report to provide an understanding of the effect these issues have on the patients who experience them, with many respondents to the survey offering accounts of poor care from the system and providing examples to rein- force the data collated within the report. Estimates on the financial impact of the problems highlighted within the report put the cost of the emer- gency readmissions caused by the poor discharges practises at around £2.4 billion a year, making change to these systems a vital aspect of improving patient care, as it will improve both their wellbeing and the financial status of the health service. The results were not entirely negative with the report showcasing examples of hospices, charities and initive which aim to provide a better standard of healthcare to patients, particularly the most vulnerable. Overall Healthwatch England were keen not to offer recommendations on change but instead highlighting the issues and presenting the health service with a challenge. The aim of the report by the consumer champion for health and social care was to ensure that these issues were noticed by the authorities within the service to help improve care for vulnerable patients. The widespread issues identified by the report will re- quire resolving if the service is ever to attain any sort of patient satisfaction. With constant threats to the service as the government constantly cuts the money to pay for the NHS, managers within the trusts need to work on fixing these problems for the sake of their patients. The report could potentially be utilised within the pri- vate sector of healthcare also, with a view to improving patient care and discharge services across the board.