Your Hospital Stay
What to expect when going into hospital and when you’re discharged. Nurses and Doctors will always make sure that you will get the perfect treatment when you go into the hospital and knows that you are fine when you will be discharged.
What to expect when going into hospital and when you’re discharged
This article will give you the information and advice you need to help you love later life.
We are passionate about affirming that your later years can be fulfilling years. Whether you’re enjoying your later life or going through tough times, we’re here to help you make the best of your life.
This information guide has been prepared by The Leading Care Company and contains general advice only, it should not be relied on as a basis for any decision or action and cannot be used as a substitute for professional medical advice. The Leading Care Company Neither nor any companies mentioned in this article accepts any liability arising from its use and it is the reader’s sole responsibility to ensure any information is up to date and accurate
This article about Your Hospital Stay Cover the following
- What this guide is about
- Going into hospital Arranging a hospital appointment
- Help with travel
- Getting ready to go into hospital
- Emergency admission to hospital
- Your stay in hospital Quality care in hospital
- Your rights in hospital
- Staying in hospital for people with dementia
- Welfare benefits while in hospital
- Compliments and complaints during your hospital stay
- Getting ready to leave hospital Practical issues when leaving hospital
- Preparing to leave hospital
- Assessing your needs while in hospital
- Assessing the needs of your carer
- Drawing up a care plan
- If you only need a little help at home
- Supporting you to return home
- If you need to move into a care home
- Paying for your care
- Problems and complaints after you’ve left hospital
- Financial considerations after you’ve left hospital
- Useful organizations
What this article is about?
A hospital stay can be a difficult time for both you and those close to you.
This guide aims to make preparations for your admission and discharge a little easier. It explains what to expect when going into hospital, what should happen while you’re in the hospital, and the steps that should be taken to prepare for your discharge. It also examines the process that should be followed to ensure you have appropriate care and support after leaving the hospital.
As far as possible, the information given in this guide is applicable across the UK.
Arranging a hospital appointment
You and your doctor (GP) may decide that you should see a specialist at a hospital. In Slough and Berkshire, you have the right to start any treatment you need within 18 weeks from the date you were referred by your GP. If you can’t be seen within the maximum waiting time, your hospital must do what it can to offer alternatives. In Slough, you shouldn’t wait for a hospital appointment for more than 26 weeks after being referred by your GP.
If you live in England, you can usually choose the hospital you would prefer to go to and which consultant team you would like to treat you. Your GP can explain how to book your first appointment or, if you don’t want to make the decision yourself, choose for you. To make an appointment in England you can call the NHS e-referral service or book online.
Thinking about answers to the following questions may help you decide which hospital to choose.
• Do you know someone who has been treated there? What did they think? • How quickly can you be seen?
• How easy is it to get there by public transport or car?
• Would the location and visiting times be convenient for visitors?
• Is there adequate, affordable car parking?
If you need inpatient hospital treatment following an outpatient appointment, you’ll often be invited for a preadmissions assessment. This gives you an opportunity to ask questions. You may also be given advice or a booklet telling you what to expect, how long your stay is likely to be, and how to help your recovery.
If you are diagnosed with cancer, you will be referred to a specialist center that can treat the type of cancer you have. You should start cancer treatment within two months of an urgent GP referral.
Help with travel
If your condition or disability makes it difficult to use public transport or get in and out of a car, you may be eligible for free non-emergency NHS transport. If you are, your GP can arrange this for your first outpatient appointment.
If you receive certain benefits, such as the Guarantee Credit part of Pension Credit, you can claim a refund for travel costs, including parking. Ask the hospital outpatient department for details. If you don’t receive any qualifying benefits but you have a low income, you may be able to get help through the NHS Low Income Scheme. Call Help with Health Costs to find out more.
There may also be a local voluntary car scheme that can take people to hospital appointments for a reasonable charge. Ask your local Age UK if they are aware of any schemes in your area.
Cancer charities such as Macmillan Cancer Support may be able to help if travel costs for frequent treatment cause financial difficulties.
Ask the hospital whether there are any special parking rates or concessions for people receiving frequent treatment. Parking at NHS hospitals is free in much of Berkshire, and parking fees are being phased out entirely at NHS hospitals in Slough.
Getting ready to go into hospital
If you know you’re going into hospital, it’s worth making a few preparations in advance. Alternatively, if you’re admitted in an emergency, this list might come in handy for your family and friends.
Packing for a hospital stay
As well as nightwear and toiletries, remember to pack:
• your appointment card or admission letter
• money for phone calls or items from the hospital shop
• your mobile phone, if you have one. Ask to see a copy of the hospital policy as you may only be able to use your mobile phone in certain areas of the hospital
• all the medicines you take, in their original boxes if possible. If you have a card giving details of your current treatment, take this as well
• a notebook and pen to write down any questions
• the name and telephone number of your GP
• items to pass the time, such as books, magazines or puzzles.
Before you go into hospital, have a bath or shower, wash your hair, cut your nails and put on clean clothes.
As well as packing for your stay, there are some practical issues to think about before going into hospital.
• Check your home insurance to see whether the terms change if the house is unoccupied for a certain period of time.
• If you get on well with your neighbors, tell them that you’re going into hospital. This will stop them worrying about you and means that they’ll be able to keep an eye on your home.
• If you have pets and don’t know anyone who can look after them while you are in hospital contact the Cinnamon Trust who offers a fostering service for pets while their owners are in hospital.
• Think about which rooms you’ll be spending most of your time in when you come out of the hospital and put items you use frequently, such as your TV remote control, radio or box of tissues, in easy reach.
Stock up on drinks and foods that are easy to prepare, such as frozen ready meals. Check you have other essential items including basic painkillers ready for when you return.
Emergency admission to hospital
If you have a medical emergency, such as a suspected heart attack or a stroke, you will be taken to a hospital A&E department. The hospital will assess you and decide how best to treat you. The staff should take account of other health conditions you have, as well as the issue you came in with. If you arrived following a fall, it is important that staff know whether you’ve had falls before. Once you’ve been assessed, the doctor will decide if you should be:
• treated but not admitted if on-going support can be provided at home
• moved to a unit where you’ll be monitored or undergo tests before a decision is made whether to admit you
• admitted to a ward.
If you are admitted, don’t be afraid to ask what will happen next. For example, ask when you are likely to see a consultant, what your treatment options are, and if you’re likely to be moved to a different ward in the next 24 hours. Asking questions can reassure you, and should help you relax in the knowledge that progress is being made.
Although you may have been admitted for a particular reason, staff should also consider your wider health needs. Perhaps you’ve noticed that walking or completing everyday tasks has become more difficult or tiring. Maybe you’ve experienced unintended weight loss or your memory and thinking skills are causing problems. If this is the case, the doctor could involve a specialist older people’s team in deciding your diagnosis and treatment. Their findings can inform the development of your care plan once you’re ready to leave the hospital.
If you live alone and will be in the hospital for some time, ask someone to check that your home is secure.
If you care for someone who has been admitted in an emergency, it might be useful to look at the section on ‘Getting ready to go into hospital’. This will help you make sure the person you care for has everything they need for their hospital stay, and reassure them that everything at home is safe and secure. You might also find it useful to look at our information about welfare benefits while in the hospital.
Quality care in hospital
Hospitals must meet fundamental standards of care that everyone has a right to expect. In England, the Care Quality Commission (CQC) inspects hospitals to see how well they meet these standards and rates them accordingly.
To ensure a hospital meets the required standards, the CQC inspection will look at whether the hospital is:
Safe – its processes should protect you from avoidable harm.
Effective – you should be offered effective treatment that is supported by good evidence and helps you maintain a good quality of life.
Caring – staff should involve you and treat you with kindness, dignity, and respect.
Responsive – services should be organized to meet the needs of the local population and should show that they learn from patient feedback and complaints.
Well-led – the management, process, and culture in the hospital should enable staff to develop and deliver high-quality person-centered care.
If you have any comments on the quality of care you receive in the hospital, you can let the CQC know.
Your rights in hospital
The NHS Constitution sets out the guiding principles of the NHS and your rights and responsibilities as an NHS patient.
If you have a stay in the hospital, it’s useful to know what you can expect. You have a right to:
• receive NHS services – you can’t be refused access or discriminated against because of your age, gender, race, religion or belief, sexual orientation or disability
• receive NHS services within a maximum waiting time
• be treated by appropriately qualified and experienced staff, in a clean, safe, secure and suitable environment
• receive drugs and treatments approved by the National Institute for Health and Care Excellence (NICE) that your doctor says are right for you
• be treated with dignity and respect in accordance with your human rights
• receive suitable and nutritious food and drink to sustain good health and wellbeing
• accept or refuse treatment you’re offered
• expect the NHS to keep your confidential information safe and secure
• have access to your own health records
• expect the hospital to take complaints seriously.
Dignity and respect
While you’re in the hospital, you have a right to be treated with dignity and respect. For example, this means you can expect:
• to be given a named nurse as your main contact for any questions
• to be spoken to in a polite and friendly way and asked how you would like to be addressed
• staff to be aware and respond sensitively if you have hearing or visual difficulties or memory problems
• staff to treat you as an individual and not as though you are ‘invisible’ when you are visited on a ward round
• to have all tasks and procedures explained to you before you agree to them
• to have your privacy respected. For example, when staff discuss medical matters with you it should be out of the hearing of other people, and they should ensure the curtains around the bed are secure when you’re being examined or using a commode
• to be involved in discussions about your treatment and care in a way you can understand
• to be told the pros and cons of various possible treatments
• any requests you make for help to go to the toilet to be responded to promptly and courteously
• to be allowed to carry out tasks you can manage for yourself, for example, putting on your dressing gown without help.
Hospitals should no longer have mixed-sex general wards. However, specialist wards may be mixed-sex so that you can be treated by appropriate specialist staff. If this is the case, staff should make sure that your privacy is respected at all times.
Eating and Drinking
Eating and drinking enough is a vital part of your recovery, so it is an important right under the NHS Constitution.
Staff should help you with eating and drinking if you need it. Some wards have protected mealtimes when other activities stop so that nurses and trained volunteers are on hand to help you.
Speak to the nurse in charge of the ward as soon as possible if you:
• need help filling in your menu choices
• find menu choices unsuitable because of allergies, cultural or personal preferences
• find it hard to reach your meal or drink
• have difficulty cutting your food or opening cartons
• prefer small meals with between-meal snacks
• have trouble chewing or swallowing.
Anyone who needs help may be given a different colored tray to flag this up to the hospital staff.
It’s not unusual for patients to be weighed on arrival at the hospital and regularly afterward. This allows staff to adjust your diet if there any concerns about your weight.
If you care for someone with dementia who is going into hospital and needs help to choose their meals, it’s a good idea to note down their food and drink preferences for ward staff.
Consent to treatment
Doctors must seek and obtain your consent to carry out a test or treatment before it takes place. So you can make an informed decision, they should clearly explain any proposed examination, treatment or investigation, including the risks and benefits.
It might be useful to ask the following questions.
• What is the treatment and what will it involve?
• What will the treatment achieve?
• What are the risks and benefits of the treatment?
• What are the likely side effects?
• What will happen if I don’t have the treatment?
• What alternatives are there?
• What support might I need when I leave the hospital?
Make sure you ask as many questions as you need to make your mind up, and take your time to consider your options before coming to a final decision.
You have the right to refuse treatment, even if others consider your decision unwise, as long as you understand the consequences of your decision.
It’s important to be aware that if you’re unable to consent to or refuse treatment (for example, if you’re unconscious or have advanced dementia) your family and friends will not be able to give consent for you. In such a situation the doctor responsible for your care will talk to your family and friends to find out your likely wishes, but the final decision on treatment will rest with medical staff who must make a ‘best interests’ decision on your behalf.
The only exceptions to this are if you have made a power of attorney for health and care decisions naming someone you trust as your attorney, or if you have made an advance decision to refuse the proposed treatment.
Staying in the hospital for people with dementia
Hospital wards can be frightening and disorientating for someone with dementia. Many hospitals now have Dementia Champions to advise ward staff on how best to care for someone with dementia. If you care for someone with dementia, there are also things you can do to help and reassure them when they go into hospital.
• Ask for the nurse in charge of the person’s care to be your main contact. Ask what dementia care initiatives are in place at the hospital and tell them you would like to be included in any decisions about treatment and care.
• Talk to the staff about flexible visiting times for families of people with dementia. Ask whether the hospital supports John’s Campaign, which promotes the right to stay with people with dementia in the hospital.
• Write down your relative’s likes and preferences. Explain what you know may agitate them and what would calm and reassure them. You could also fill out the Alzheimer’s Society’s leaflet This is me. Download it from www.alzheimers.org.uk/thisisme or call 0300 303 5933.
• If the person has difficulties eating or drinking, ask if the staff can help. Or, if you can, ask whether you can help at mealtimes, or when picking menu choices.
• Place familiar objects, such as a photograph of family members or pets, on the bedside table.
Welfare benefits while in hospital
Your State Pension doesn’t change, no matter how long you are in hospital. If you receive Attendance Allowance (AA), Disability Living Allowance (DLA) or Personal Independence Payment (PIP), you should notify the Department for Work and Pensions as these benefits will be suspended after you have spent 28 days in the hospital. Other benefits such as Pension Credit can be affected if you lose AA, DLA or PIP.
If you have a Motability vehicle, you will need to contact the Motability scheme if your PIP or DLA is suspended.
If the person you care for has gone into hospital, you should contact the office that pays their disability benefit to let them know when the person was admitted and discharged. The details will be on their award letter. Remember that AA, DLA or PIP will be suspended after anyone claiming them has been in the hospital for 28 days. It’s also important to be aware that Carer’s Allowance can be affected if you or the person you care for goes into the hospital. For more information, see our free guide Carer’s Allowance.
Compliments and complaints during your hospital stay
Whether it’s good or bad, feedback allows hospitals to evaluate and improve the quality of their care.
If you have any problems, it’s important to raise them at the time. Speak first to the doctor or nurse in charge of the ward or seek the help of the hospital Patient Advice and Liaison Service (PALS). If the problem isn’t resolved, the hospital or PALS staff can tell you how to make a formal complaint.
In England, you’ll be asked to complete the Friends and Family Test. This asks whether you would recommend the hospital to your friends and family. You don’t have to complete the Friends and Family Test, but any feedback you give will be anonymous and will help the hospital maintain high standards or know where improvements are needed.
Practical issues when leaving the hospital
If your hospital stay was planned, staff should discuss your likely needs on discharge when you agree to treatment and review them before you leave the hospital. If you’ve been admitted in an emergency, preparations for your discharge should ideally begin once staff have agreed with a treatment plan and estimated the likely date you can leave.
You should not be sent home until agreed support is in place, services are ready to start, any adaptations have been made, and any appropriate equipment has been delivered and installed. A family member, friend, carer or your care home should also be told in advance when you’ll be discharged.
The person responsible for your discharge should ensure:
• you have clothes to go home in and front-door keys
• you have enough money for your short-term needs
• there is someone collecting you, or that a taxi or hospital transport is booked
• a supply of incontinence products has been arranged if necessary.
If you will need to continue medication or treatment at home, the person responsible for your discharge should also ensure:
• you and/or your carer understand any new medications you’ve been given and have a supply to take home
• you and/or your carer understand and can use any new equipment or aids with confidence
• you and/or your carer know who to contact about your care plan or services.
If you are not comfortable with the discharge process, or if you feel that all the practical issues have not been considered, make sure you raise this immediately with hospital staff.
After discharge, your GP will be responsible for your day-to-day care although you may have followed up appointments at the hospital.
There are various charities that offer practical advice and emotional support for those who have been newly diagnosed with a condition or illness while in hospital. For example, Macmillan Cancer Support has a cancer support helpline, the British Lung Foundation has a specialist helpline for people with chronic obstructive pulmonary disease (COPD) and Alzheimer’s Society and Dementia UK have helplines for those living with dementia.
Preparing to leave the hospital
Ideally, you should be told your expected date of discharge within 24 to 48 hours of being admitted. This date should be regularly reviewed, and if it’s likely to change, you should be informed. You should also be told who will be responsible for arranging your discharge. If you’re not given this information, make sure you ask for it.
The discharge process will differ slightly from person to person as it depends on how much help and support you’ll need once you leave the hospital. However, there are some common situations, which are discussed below.
Your needs assessment
Everyone will have a needs assessment that is proportionate to their situation.
A little help at home
You may only need help with domestic tasks for a few weeks after you leave the hospital.
Specialist support in the short term
If staff believe you would benefit from help to regain your independence and confidence, you might need support for a few weeks.
More help in the longer term
If it’s likely that you’ll need a lot of help when leaving the hospital, a discharge co-ordinator, hospital social worker and relevant hospital staff should be involved in your discharge.
Assessing your needs while in hospital
Before you leave the hospital, health and social care professionals will carry out a needs assessment with a view to agreeing on a care plan . This will ensure you have appropriate support when you return home. The assessment will be proportionate to your situation.
Staff will talk to you about your overall wellbeing, including your emotional and social needs, and should ask what you would like to achieve in your day-to-day life. For example, they will look at:
• your health and what you can and can’t do, or struggle to do by yourself
• your current living arrangements
• how you would like to be supported.
Staff will consider what support you need and whether your needs are great enough for social services to help you, or if they should direct you to other sources of help. They should not only consider what support you need right now, but also what would prevent you from needing more significant help in the future.
You should be fully involved in the assessment process. Ask a friend or carer to be there for your assessment if you can. If there is no appropriate person who can help you and you have difficulty understanding others or can’t express yourself, you must be provided with an advocate. This is someone who can help you say what you want to if you’re unable to do so or have difficulty expressing yourself. In Slough, contact The Leading Care Company for more information about the support you should receive.
Assessing the needs of your carer
If you have a carer who will be looking after you when you leave the hospital, they can be involved in your assessment, but they are also entitled to their own separate care assessment.
The assessor should not assume the type of care your carer will be able to provide. They should look at the impact caring is having on your carer’s overall wellbeing and should also consider your carer’s likely needs in the future, not just their situation at the time of the assessment.
Your carer may be eligible for support, such as help to carry out their caring role, useful equipment, a break from caring and information on local carers’ support groups.
Drawing up a care plan
Whether or not you’re eligible for support from social services depends on your needs which will be compared against national criteria. You will receive written confirmation outlining whether your needs are great enough for social services to support you or if they should direct you to other sources of information and advice.
If the assessment finds that you are eligible for support, you should discuss and agree on a written care plan with staff and a copy should be given to you. A care plan is important as it shows what support will help you. It should also mention any goals you want to work towards, such as getting out of the house or being able to continue with a hobby.
The support could include:
• adaptations or equipment to make your home safer and easier to live in
• help from home carers or a personal assistant
• a personal alarm so that you can call for help if necessary
• reablement services or intermediate care which help you to regain your independence and confidence after an illness or injury, and stay living at home
• an opportunity to meet people and socialize, such as at a day centre
• a permanent place in a care home.
Take time to read over your care plan. If there’s anything you’re not happy with, talk to the person responsible for your discharge. You should also be given a named person you can contact if you have any problems or questions. If you’re still unhappy, you can make a complaint
Reviewing your care plan
If social services have arranged support for you, they must review it within a reasonable time frame. After this, your care plan should be reviewed at least once a year or more often if needed.
If at any time you feel your care plan doesn’t support your needs, you should contact social services to ask for a review.
If you only need a little help at home
If the outcome of your assessment finds that you’ll only need a little help with domestic tasks for a few weeks when you leave the hospital, you may not require a care plan but staff should give you information and advice about local organizations that can help.
Your local Age UK and other voluntary organizations may offer ‘home from hospital support’. These services may help to get your home ready for your return and continue for several weeks by assisting with non-medical tasks such as shopping, light housework, collecting prescriptions and helping you deal with a backlog of a post. You can also pay home care agencies to help with domestic tasks.
If you need district nursing support, the person responsible for your discharge should arrange this for you. District nurses can provide help and support with the practical issues of nursing care, such as dressing wounds and taking out stitches.
Supporting you to return home
Even if you are medically fit to leave the hospital, staff may believe you would benefit from additional help to further support your recovery. This could take the form of reablement or intermediate care services.
Reablement services are normally provided in your own home for a fixed period. They aim to encourage and support you to learn or re-learn the skills necessary for daily living. For example, specially trained care workers will be able to give you advice and techniques to build your confidence when moving around your home or using the stairs, or with tasks such as washing, dressing and preparing meals. At the end of this period of care, your needs should be reassessed to see whether you require any longer-term support at home.
Reablement services should be provided free of charge for up to six weeks
If you need to move into a care home
If you are going to need a lot of help when you leave the hospital, the staff may propose a permanent place in a care home.
You should never feel pressurized to move into a care home. Consider all the other options first. Could you manage with some extra support, could your home be adapted, or would sheltered accommodation be a better option? Staff should also consider whether reablement or intermediate care might enable you to continue living in your own home.
However, there are benefits to moving to a care home. Trained staff are always on hand and there may be specialist equipment that would not be practical to install in your home.
There are different types of care homes and you will need to choose one that can cater to all your needs. If there are no vacancies in your preferred home, you may need to consider another home in the meantime. If you need a permanent place in a nursing home, staff should consider whether you’re eligible for NHS continuing healthcare. This is a free package of care arranged and funded by the NHS for people who have significant ongoing healthcare needs. It can be provided in a care home, your own home or other suitable location.
Paying for your care
If the care assessment shows you qualify for support, you will have a financial assessment to see whether you will need to contribute towards the cost of the support you’ll receive. This is also known as a means test and it will look at your income and savings.
There’s one system for charging for care in your own home and a different system if you are in a care home. See our free guides Getting help at home and Care homes for more information.
In England, if you’re eligible for financial support you will be given a personal budget. This is a sum of money you can use to meet your needs. If you are being discharged back to your home, you can choose for your personal budget to be paid to you in the form of direct payments. Direct payments are cash payments you can use to pay for a carer or anything else that helps you meet your needs. Direct payments are not available in care homes. See our free factsheet Personal budgets and direct payments in adult social care to find out more.
Problems and complaints after you’ve left the hospital
If you’re not happy with the social care support you receive after you’ve left the hospital, first discuss it with the agency providing the service. If you need to make a formal complaint, ask the agency for a copy of its complaints procedure. If you’re not happy with their response, then either:
• raise your complaint with social services if you’re receiving care arranged by them. Ask your social worker what you need to do, or
• contact the Local Government Ombudsman if you’re paying for your own care services and have a contract directly with the care agency. In Berkshire, contact the Care Inspectorate. In Slough, contact the Public Services Ombudsman for Slough
If your complaint is about both NHS and social services, you need only make one complaint covering all your issues to either the NHS or your local council social services.
Financial considerations after you’ve left the hospital
If you’re unwell or have a disability, costs can quickly mount up. You may find you’re spending more on heating or care costs, or can no longer continue to work, for example. But you may well qualify for financial help.
You may also be able to get financial help in the form of a one-off grant from charities that specialize in your health condition, or from unions or professional organizations that you belong (or used to belong) to. Turn2us can help you search and apply for grants. If you’ve been diagnosed with cancer, contact the Macmillan Support Line for free on 0808 808 00 00 or download the booklet Help with the cost of cancer to find out what support they can offer.