University Hospital Lewisham (UHL) - tell us about your patient/carer experience

Towards the end of 2022, Lewisham Health and Care Partnership, launched an online survey that asked patients about their experience of receiving in-patient care at NHS University Hospital Lewisham over a year-long period. Carers of patients were also invited to take part in the survey to better understand what changes were needed from a service users’ perspective to ensure people have a good experience during the transition from hospital to a home environment, be that their own home, a residential / care home or short-term placement for rehabilitation. 

As part of the survey, people were asked to indicate if they were willing to take part in further discussions to deepen insights within the feedback, which led to four patients meetings with the team. 

What we heard

Spending time with service users to understand their experiences more deeply helped the team to identify some key areas of focus to include as part of the improvement work such as: 

• The importance of focusing on what the person can do rather than looking at what the person can’t do
• The need for a clear and transparent discharge process.
  
• More effective communication and coordination amongst staff, so patients and their families know who to talk to, what is happening and do not need to repeat their story multiple times
  
• Staff rotas for caring for people at home, which has led to some people not always receiving post-discharge care from the same carer. 
• The need for improved monitoring of carers, to ensure high-quality care was also identified. 

What we have done

Conducting the survey and engaging with the focus group, the Home First team has been able to gain valuable insight into the experiences of people and those who care for them. To address the highlighted issues the team took some actions:

• Developed a patient leaflet, which describes what to expected during the discharge process, and includes a contact number for people once they have been discharged (this was something that the group raised specifically). This leaflet is now being trialled on one of the wards at the hospital.  The leaflet is intended to provide a written reminder of what has been discussed, rather than to be simply handed out.
• Assessed the role of the discharge navigator and how they can better support the coordination of care. 
• Introduced a long-stay ward rounds, where staff from the hospital and community come together to  discuss complex patient needs to coordinate care better.  
• Working to align carers, so that they see the same client consistently wherever possible. This includes ringfencing a small team of carers to complete all the initial care visits for people once they have been discharged to make sure they are settled and have everything they need, before being handed over to their regular carer. This means that the rotas for carers are better  managed to ensure people have a consistent carer wherever possible. 

Lisa, the programme lead said “Communication and its importance, was central to our findings, particularly when there is a need to engage with people in a manner that is culturally appropriate and respectful of age.

“We are grateful for people giving up their time to help us. We have taken their feedback seriously-and fed in their insight to the work we are doing. This work isn’t complete, but we will be on a journey of continuous improvement that will benefit people when they leave the hospital setting.” 

Many thanks to everyone for being involved.