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Discharge planning is still a priority

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Hospital and community need to work together Hospital and community need to work together

In 2014, the QNI published a survey of more than 1000 district nurses. Three major issues were identified from the data: workforce, mobile working and discharge planning.

When I first heard that discharges were a major issue, I was disappointed. I thought back to my learning as a student nurse when it was impressed upon us relentlessly that the plan for discharge should be made when a patient is first admitted to hospital.

I was concerned to learn that almost 40 years later this would be such a major problem, when the importance of safe and seamless transfers of care between hospital and home ought to be understood by all professionals in the system.

In response to the survey findings, in 2015 the Department of Health funded the QNI to undertake a project to explore good practice in discharge planning. The project report has now been published online at:

The review of the evidence has shown that there is no single solution to the issue, but several: the report provides examples of areas in the country where discharge planning is working well, with consistently positive patient outcomes. These are the areas that can provide blueprints for services in other localities seeking innovation in this area of practice. They have worked to address the challenges of safe, seamless transfers of care with solutions from frontline practitioners, supported by whole system changes.

Communication is highlighted in the report as a major barrier in discharge planning. This is not just about the right procedures being in place and utilised effectively by all but an understanding of each others’ roles. As a chief nurse of a hospital recently told me, community nursing skills and the complexity of the care required in the community are very poorly understood by our hospital based colleagues.

When reflecting on the discharge planning report, I believe the main issues from our original district nursing report are all interrelated. There is no doubt that without the right staff with the right skills working together, discharges of people with ever more complex conditions to the district nursing service will be problematic. Furthermore, without the right technology to share patient records on mobile devices, discharges cannot be seamless.

Is it time we had a major ‘show and tell’ event where our hospital-based colleagues are offered the opportunity to shadow a district nurse for a day? Sharing the reality of everyday practice in the community may help to create a shared perspective of what ‘really good’ can look like if all parties are to fully understand each other’s roles in supporting patients in the transition of their care.

Crystal Oldman, chief executive, Queen’s Nursing Institute

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