The care homes project, which was supported by the Royal College of Physicians (RCP) Health Informatics Unit (HIU), evaluates how flows of information in and out of care homes can impact the work of care staff following hospital discharge.
In order to form a representative view of the sector, we ran a series of interviews with care home managers about information flows, including those with GPs, social workers and hospital admissions and discharges. The interviews found that while care homes are increasingly using technology and have developed digital processes internally for managing care, these are not connected to the wider health and social care system. The interviews informed the design of the wider online survey with care homes, which received over 230 responses.
Survey respondents felt the main problems they face when a resident is discharged from hospital related to poor communication, lack of information and the discharge process. Potential solutions offered via the survey included: improving understanding of care homes, better planning of discharge and checking by the hospital that things were in place, improved handover to the care home, higher quality discharge summary information and discharging patients at appropriate times.
While some care homes said they regularly receive discharge summaries for service users, others said the available information was ‘variable’ with summaries being issued only half of the time. Of the care homes receiving discharge summaries, nine in 10 still get paper records, though two-thirds of those interviewed said they had their own digital processes in place. In the survey, care homes also identified the discharge information that was crucial to facilitating continued care, which includes medication, mobility issues, diagnoses, treatments and long-term care plans.
Findings from the survey and the interviews were combined in a report and will be analysed alongside data from NHS Digital’s social care programme, to start informing potential solutions to improve these information flows. In the coming months, the NHS Digital social care programme will be running a series of workshops to co-design solutions and test these with care homes.