Carer experiences about hospital arrangements through to discharge

On December 7th 2023, Healthwatch Wandsworth held an event in collaboration with St George's Hospital for carers supporting a family member or friend leaving hospital. We created a space for carers to meet fellow carers in the community, receive information and resources, and share their experiences and insights into arrangements for leaving hospital.

What we did

We held small group discussions around the following questions:

• What can we give carers to help them support the person they care for? Follow up questions included: How can we involve and include carers on the ward? What is important to consider about a carer’s lifestyle, needs, and culture?
   
• What things must the NHS consider before offering virtual wards (e.g., cultural sensitivities, lifestyle of patient/carer, suitability of home)?

The ideas they shared with us resulted in the following findings.

Key findings

What we can give carers to help them support the person they care for

• Create awareness around the importance of carers’ taking care of their physical and mental health so they can support their friend or family member upon leaving hospital. This may include signposting to support, especially around bills.
   
• Keep carers integral to all aspects of their friend or family member’s hospital stay. Carers value open, respectful, and reciprocal communication throughout the diagnosis, care, and discharge process.
   
• Consider language supports already in place and ensure communication is in plain English and communication support is provided where needed.

Virtual ward considerations

• Ensure that carers are kept integral to all aspects of a virtual ward stay and that reciprocal communication is supported through having information available in multiple languages and plain English.
   
• Evaluate the suitability of virtual wards for patients on a case-by-case basis in collaboration with carers and their individual varied needs and circumstances.
   
• Provide an FAQ sheet to carers as well as bespoke training for carers about virtual wards and equipment to provide clear information and expectations around the wards.

You can find out more about the carer's recommendations in the report below.

What happens next

We will share this carer feedback with multiple organisations involved in supporting carers and hospital discharges.

In February 2024, we attended the Carer Project Steering Group at St George's Hospital to discuss some of the feedback and hear about what developments could be possible.

We heard about plans to make sure that information about carers is captured on the hospital system. The hospital is increasingly making sure that carers are signposted to support from carers centres (borough specific) through the introduction of a carer contact sheet and by raising awareness across the organisation using multiple methods including training sessions, newsletters, events, reports, and presentations.

Some wards are piloting initiatives that welcome carers to wards and provide information about hospital discharge. A carer information pack is being trialed on some wards with the potential for expansion. We also heard about the importance of communicating appropriately with patients, carers, and families. The Trust is focusing on the accessible information standard to make system wide improvements. Adding a page on the St George’s website with information for carers in a variety of formats is in the planning stages. An intranet page for staff is also planned to support and empower staff to support unpaid carers. We’ll continue to follow progress on these initiatives and responses to carer feedback as part of the board.

We have submitted our report to the Health Innovation Network to inform their overall evaluation of virtual wards and are awaiting an update on the response of NHS decision makers to the findings.

Support for carers currently in Wandsworth

If you help someone in Wandsworth with their day to day living, one key place to look for advice and support is Wandsworth Carers' Centre. They can signpost you to many other sources of support that you might need.

You can also speak to the council or Wandsworth Carers' Centre about an assessment. More information is available here.

Helping someone else, our own health and wellbeing can often take second priority. We would encourage you to make sure you think about maintaining your own wellbeing to help you and the person you care for. You can speak to your GP and they will give you longer appointments if you are a carer. It is also worth considering how to maintain your mental health and wellbeing. Wandsworth Carers' Centre and Talk Wandsworth could help.