Scottish Inpatient Patient Experience Survey 2014 Volume 1: National Results

9. Results - Leaving Hospital

Summary

• Nearly 8 out of 10 patients (79%) rated the arrangements for leaving hospital positively, up 4 per percentage points from 2012.
• However of all the overall rating questions in the survey, patients were least positive about arrangements for leaving hospital.
• Delays to discharge on the day of leaving were a problem for two in five patients, mainly due to waiting for medicines - over half of the delays were due to this. Around one in six experienced delays over four hours.
• Of those requiring help and support to be arranged for after leaving hospital, only 71 per cent were confident it had been arranged 'completely', while 20 per cent felt it had been arranged 'to some extent' and 9 per cent felt that it had not been arranged.
• An area where patients were less positive related to hospital transport - nearly one in five people who were eligible for hospital transport were not happy with how it had been arranged.

Introduction

9.1. Timely and appropriate discharge from hospital is an important part of the patient journey. The patient and any carer(s) should be provided with clear information about the discharge process and any follow-up care and support required after leaving hospital. We asked patients a series of questions about preparation for hospital discharge, arrangements for going home, delays on the day of discharge and experiences of hospital transport and medicines.

Overall rating of arrangements for leaving hospital

9.2. Overall patients rated the arrangements made for leaving hospital fairly positively with 79 per cent of patients rating these arrangements as excellent or good (Chart 12). However of all the overall rating questions in the survey, patients were less positive around arrangements for leaving hospital compared to other areas

Chart 12 Overall, how would you rate the arrangements made for your leaving hospital? (%)

Delays on the day patients left hospital

9.3. This year three new questions were introduced relating to delays experienced by patients on the day they left hospital.

9.4. Two in five patients (39%) experienced a delay on the day they left hospital, mainly because the patients had to wait for medicines (Charts 13, 14) .

Chart 13 Were you delayed on the day you left hospital?

Chart 14 Main reason for which patients were delayed on the day they left (%)

9.5. Just over half of the patients who experienced a delay on the day they left hospital (51%) reported waiting up to 2 hours before they could leave, while the other 49 per cent waited two hours or more (Chart 15).

Chart 15 How long was the delay? (%)

Length of time in hospital

9.6. Further questions were also added to or amended in the 2014 survey to capture patients' experience of the total length of time in hospital and to make the link with the care when leaving hospital.

9.7. A large majority of patients (88%) felt that the length of time they were in hospital was reasonable, while eight per cent felt that it was too short and four per cent felt that it was too long.

Arrangements for help and support at home

9.8. Eighty-five per cent of patients felt confident that they could look after themselves when they left the hospital.

9.9. Patients were asked whether they felt confident that help they required at home had been arranged for them before they left hospital. Over a third of patients (35%) reported they did not need any help arranged before leaving hospital. Of the remaining 65 per cent who needed help to be arranged for them, 71 per cent were confident it had been arranged 'completely', 20 per cent felt it had been arranged 'to some extent' and 9 per cent felt it had not been arranged.

Arrangements for leaving hospital

9.10. Patients were asked how much they agreed or disagreed with four statements about the arrangements made for them when they left hospital. The results are shown in Table 14. There were no statistically significant changes since the 2012 survey or the 2011 survey.

9.11. The percentage of patients answering positively ranged from 72 per cent ('I was told about any danger signs to watch for when I left hospital') to 83 per cent ('My family or home situation was taken into account when planning for me leaving hospital').

9.12. A new question was introduced this year, which related to patients being involved in decisions about leaving hospital. Just over three quarters (76%) of patients agreed that they were involved in decisions about leaving hospital.

Table 14 Summary results of statements asked about the arrangements made for leaving hospital (%)

	Negative	Neither positive nor negative	Positive	Change in Positive Per Cent from 2012
I was involved in decisions about leaving hospital.	11	13	76	n/a1
My family or home situation was taken into account when planning for me leaving hospital.	8	9	83	0
I knew who to contact if I had any questions after leaving hospital.	13	7	80	0
I was told about any danger signs to watch for when I left hospital.	17	11	72	0

Note:

1. New question added to the 2014 survey.

Patient Transport Service

9.13. Some patients are eligible for Patient Transport Service based on their medical or clinical needs^[22]. We added a question in the 2014 survey to capture patients' experience of arranging such transport.

9.14. Most patients reported they were not eligible for hospital transport (85%). Of the remaining 15 per cent who were eligible, 82 per cent were happy with how this had been arranged and 18 per cent indicated they were not happy.

Medicines

9.15. Many patients are given medicines when leaving hospital and it is important that they understand what their medicines are for, how and when to take them, and to understand the possible side effects and know what to do if they have any concerns to reduce adverse events. The Scottish Patient Safety Programme^[23] aims to help provide safe and effective medicines management.

9.16. Patients were asked if they had been given medicines to take home when they left hospital. Over three quarters (77%) indicated that they had been given medicines to take home. These patients were then asked how much they agreed or disagreed with four statements about these medicines (Table 15).

9.17. The percentage of patients answering positively ranged from 71 per cent ('I didn't have to wait too long to get my medicines') to 97 per cent ('I understood how and when to take my medicines'). The low rating of the statement around waiting for medicines where one in five indicated that the wait was too long corresponds with the responses to the earlier questions on delays on the day of discharge where patients indicated that these were mainly due to waits for medicines.

9.18. The results for medicines are fairly similar to those in 2012, with a slight reduction (2 percentage points) in the percentage of patients answering positively to this statement: 'I didn't have to wait too long to get my medicines'. Results are shown in Table 15.

Table 15 Summary results of statements asked about medication (%)

	Negative	Neither positive nor negative	Positive	Change in positive per cent from 2012
I didn't have to wait too long to get my medicines.	20	9	71	-2
I understood what my medicines were for.	2	3	95	0
I understood how and when to take my medicines.	1	2	97	0
I understood the possible side effects of my medicines.	9	10	81	1