The Princess Royal Trust for Carers Out of Hospital Project
Learning on supporting carer involvement in hospital discharge for policy makers, PCTs and other
health commissioners, hospitals and carers’ organisations
Aim:
The aim of The Princess Royal Trust for Carers Out of Hospital Project was to demonstrate
practical ways to support carers at the point of hospital discharge, thereby improving the health of
carers and saving time and money through avoiding unnecessary re-admission to hospital.
Overview:
The key messages from the Out of Hospital Project highlight that a holistic approach
between carers, policy makers, Primary Care Trusts (PCTs) and other health commissioners,
hospital trusts and carers’ organisations can change systems and attitudes to create a local health
service that benefits patients and their families and respects carers’ choices as partners in care.
Summary of learning and key messages:
Learning and key messages from the project
have been summarised in five sections most relevant to the following stakeholders:
1.
2.
3.
4.
5.
Policy Makers
Hospital Trusts
Primary Care Trusts
Carers’ Centres
Hospital based carers’ projects
To download a copy of the full report, see the details in Section 6.
Section One - Policy Makers

Raise recognition and support for carers to a Tier 2 priority in the NHS Operating Framework

Place a stronger emphasis on carers in the Department of Health guidance on hospital discharge

A new requirement by the Care Quality Commission that hospital trusts identify carers (not just
those who care for someone with a learning disability

Strengthen the evidence base by commissioning research to demonstrate the impact of carer
involvement in hospital discharge on NHS budgets and services

Call on national carers organisations and the carers they work with for information and advice
Section Two - Hospital Trusts

Identify a Carers’ Champion at executive level within the hospital trust who has the status to
manage the development and implementation of discharge policies and procedures

Include identification, recording and referral of carers in hospital discharge policy

Core systems, such as admission and assessment processes, must include fields to identify and
record carer details

Establish Carers Leads within all departments and wards to promote the recognition of carers

Incorporate information about carers in staff training/induction packs

Encourage carers to identify themselves to ward staff (e.g. include reference to carers in patient
information/on ward display boards)

Collect clinical audit data on the numbers of carers identified and the impact of providing carer
support on patients and hospital (e.g. improved patient experience of discharge, increased hospital
efficiency)

Include carer details in nursing information systems that distinguish between next of kin and the
carer

Call on local carers organisations for information and advice and to find out the views of local
carers
Section Three – Primary Care Trusts and other Health Commissioners

Agree carers’ standards as part of the contract with hospital trusts

Require hospital trusts to have a carers’ charter which is publicly available

Actively participate in local strategic and developmental work on carers issues e.g. local Carers’
Strategy

Call on national carers organisations for the views of carers in the region and for information and
support
Section Four - Carers’ Centres
 Be clear about the aims and intended results of carer involvement in the hospital discharge process
and relate them to national and local health priorities

Invest time in establishing positive working relationships with those in a position to effect change
within PCTs and hospitals and in NHS commissioning

Use your working relationship with the PCT and with other health commissioners and your
involvement in strategic and partnership forums to make the case for PCTs to include carers
standards in contracts with hospital trusts

Use existing relationships with PCTs and hospitals to support their work with carers e.g. staff
training; development of systems and procedures

Call on your contacts in hospital trusts and PCTs and other health commissioners for information
and support
Section Five - hospital based carers’ projects
 Clarify scope and focus of project e.g. a focus on changing and developing systems and policies; a
focus on providing tailored support to carers or both
 Allow adequate time for partnership negotiations prior to project implementation e.g. between
Hospital Trust and carers organisation/employer of carers worker(s) about partnership protocols
and the practicalities of where worker(s) will be based (e.g. telephone/IT/access to room away
from ward environment to see carers)
 Project work needs to include ongoing “marketing” of the advantage of identifying carers early and
involving them in decisions about the care and discharge of the person they care for
 The mainstreaming of carer involvement in hospital discharge requires system change
 Securing the support of a “ carers’ champion” (workers) at a high level of the hospital hierarchy will
have a positive impact on getting new systems and procedures mainstreamed as part of hospital
culture

Dedicated carers workers operating both within and outside of the hospital setting can ensure that
carers gets access to practical and emotional support around the time of discharge
Section Six – the full report
Acton Shapiro’s independent evaluation of the project “The Princess Royal Trust for Carers ‘ Out of Hospital
Project’ – Learning from the pilot projects - Final Report May 2010 can be downloaded from 14th July 2010
from www.carers.org/professionals
The Way Forward
A holistic approach to hospital discharge involving carers, policy makers, Primary Care Trusts,
other health commissioners, Hospital Trusts and carers’ organisations can change systems and
attitudes and result in better outcomes for patients and carers. The Princess Royal Trust for Carers
seeks the co-operation and commitment of all stakeholders to work together towards the
implementation of this approach to benefit carers throughout the country.
With Thanks to
Glaxo Kline Smith who funded and supported the project; the pilot projects at Swindon and Barnet
Hospitals; carers’ workers at the Carers Centres who work in partnership with The Princess Royal
Trust for Carers and project evaluators Acton Shapiro Limited