How patients can eat well after leaving hospital
Imagine someone arriving home after a week-long hospital stay, they are recovering but still very low on energy and having lost their appetite. They know that they should eat something to assist their recovery, but they open the fridge and most of the contents have gone off during their stay and there is not a meal that can be made from what is left. They do have some tins of soup, but are finding it hard to reach them and, as they do not have a microwave, they would also find it hard to stand at the stove to heat it up. They just cannot manage all this, so they make do with a cup of tea and some biscuits.
"Given the critical role it plays in our health, food should be a key consideration when planning for someone’s discharge." - Simon Shaw, Fellow
Now imagine a different person, who was visited while they were still in hospital by someone from a local support service, to figure out what help they might need to return home and regain their independence. With the patient’s consent, someone visits their house before they go home, to clear out any out-of-date food, restock the kitchen and install a microwave. They also set up a shopping support service and regular delivery of meals, and have told them about a local lunch club which they can attend once they are more recovered. This person will be able to prepare some food independently and enjoy nutritious meals prepared by others.
These two imagined people represent two very different sets of real-life experiences, which were shared with me during my Home from Hospital project. This has explored how we can make sure people eat well after they have been discharged from hospital.
Given the critical role it plays in our health, food should be a key consideration when planning for someone’s discharge. This food support should include a range of helpful options, such as sending people home with a first meal and other basics, food packages, regular hot and cold meal deliveries or support with shopping. For some, this might last for a few days, for others it could last for several weeks or be part of longer-term support.
Failure to support people can result in reduced independence and quality of life, malnutrition, increased chance of hospital readmission and increased pressure on community health services. Conversely, effective support on nutrition and hydration is an essential part of recovery, benefiting individuals and families to heal and to prevent loneliness and social isolation. It also supports health services by using budgets well, reducing hospital stays, avoiding delayed discharges and preventing readmission.
Recipe for success
Hospital discharge is usually coordinated by health professionals and focuses on shorter term needs in order to facilitate discharge. It leaves the assessment of longer term needs until after people have returned to their homes. It is therefore not a given that food needs and access will have been properly considered, beyond the days that immediately follow discharge. Having heard from numerous people working in the field, I have identified five key areas of action to ensure people have access to food when they go home from hospital.
- Developing a joined-up approach to food and hospital discharge. Putting in place a coordinated local plan and support to ensure people will have access to food when they are discharged from hospital.
- Understanding people’s needs. Ensuring that key people understand how people will access food on their return home and any support needed to do so, especially where their situation has changed since their admission to hospital.
- Navigating local support options. Making sure that key people know about all the potential support available in the local area and how to access it.
- Developing and communicating a plan. Ensuring that all key people know about how someone will be supported when they return home.
- Supporting local providers. Making sure local organisations are suitably resourced and maximising referrals to increase their reach and viability.
Showcasing good practice from around the country
There is a wealth of good practice across the country but local organisations are not as connected as they could be to share their learning and inspire others. I conducted a survey of local practitioners, patients and their families and gathered many insights into what does and doesn’t support people’s access to food when they leave hospital. I then brought together practitioners from around the country on a series of online meetings to share their experiences with each other, as well as others looking to learn from them. I have now published a guide bringing together this survey research and examples of practice in a new guide. The guide outlines the many ways food support is valuable to people, not only by providing nutrition and comfort, but also as a very tangible sign of others caring for people at a time when they may be feeling low and adjusting to a new reality. Testimonies from those who have benefited from good support speak for themselves:
- “The patient was really emotional, close to tears. He offered to pay for the food and would not let go of the bag even for the ambulance crew to carry.” - Ann Barakas, Ward Manager, Fairfield General Hospital.
- “Food Train has changed my life, I absolutely love it, you have no idea what you mean to me.” - Mr P, a programme beneficiary.
Local services and organisations work hard to support effective discharge processes and are well placed to respond to local needs. There are clear opportunities for organisations to take an enterprising approach to reach more people, support ‘good food jobs’ and use local food suppliers. But services are subject to policy and funding decisions at the national and local level. There is a clear need for access to food, nutrition and hydration to be a priority for both national and local policy on hospital discharge processes.
I hope that the guide both serves to highlight just some of the fantastic work taking place around the country and provides impetus and momentum to support provision for the long-term.
Find out more about the Home from Hospital project and connect with Simon on LinkedIn.
The views and opinions expressed by any Fellow are those of the Fellow and not of the Churchill Fellowship or its partners, which have no responsibility or liability for any part of them.