In and out of hospital 5 Foreword he British Red Cross plays a unique once they are discharged. Hospitals are not role in health and social care in the UK. always noticing when somebody comes in and Our staff and volunteers are working out multiple times. Simple measures such as Twith emergency departments across establishing somebody’s mobility needs before the country, providing ambulance support, they return home are routinely missed. Nor are transporting patients to and from hospital and homes assessed for falls hazards, which may supporting tens of thousands of older and lead to a person returning to hospital far too vulnerable people in their homes. This gives us soon. Some of our service users even told us unique insight into every stage of a patient’s they feel unsafe in their own homes. journey, from home to hospital and back again. People are getting stuck in hospital, often Our privileged position allows us to bear because of a lack of care closer to home witness to the fantastic amount of good work – particularly those living on their own. The within the health and social care system. impact this has on people and the system is But we also see the stresses, many of them hard to overstate. Older people are estimated preventable, that these services are under. to lose up to five per cent of muscle strength Crucially, we also see where people are per day in hospital, ultimately reducing falling through the gaps. their ability to live independently at home once discharged.3 This report is the culmination of a programme of research that we have undertaken, It is also vital that the health system gets better which paints a bleak picture of the stress at admitting people only when it’s medically the system is under. All too often, we see necessary and is equipped to do so safely. vulnerable people having to reach a crisis Appropriate safeguards must also be in place point before they receive support. Others before vulnerable people are discharged. are caught in an endless cycle of avoidable Our research has broadened our understanding hospital readmissions, with too many missed of these issues from the perspective of people opportunities to rectify this. at the forefront of our system: whether that Latest figures show that emergency hospital be the person receiving care or the doctor or readmissions have risen by 22.8 per cent in nurse providing it. While a lack of resources the last five years.1 Worryingly, the number underpins most of the issues set out in the of people being readmitted to hospital within report, we have tried to identify some relatively 48 hours now accounts for one in five of all simple steps that we believe could improve emergency readmissions.2 patient flow. We hope these measures will go Today we see too many missed opportunities a long way towards ensuring that more people to prevent a person’s health from deteriorating go on to live healthy and fulfilling lives. or to stop their problems from reoccurring 1 This compares to a 9.3 per cent rise in overall admissions to hospitals during the same period. Healthwatch (October 2017). 2 Healthwatch (October 2017). 3 National Audit Office, Discharging older patients from hospital, (May 2016).