Carers UK calls on Peers to support a cross party amendment, in the Health and Care Bill, to safeguard unpaid carers rights on discharge from hospital. The Health and Care Bill as it stands revokes the Community Care (Delayed Discharges, etc) Act 2003 which includes a requirement on hospitals to consult carers prior to discharge.  

The Health and Care Bill marks the first time unpaid carers rights will be removed without being replaced with additional or improved rights.  It is being debated at Report stage in the House of Lords.

Carers UK research^[1] has revealed deep concerns over the hospital discharge process, and the impact of the recently implemented Discharge to Assess model on unpaid carers. It found that too many carers felt they had not been adequately consulted or provided with sufficient information to care safely, after the person they care for is discharged from hospital.

• More than half of carers (56%) providing significant hours of care were not involved in decisions about hospital discharge.
• Two thirds of carers (66%) did not feel listened to about their willingness and ability to care by healthcare professionals.
• The majority of carers (61%) were not given enough information and advice to care safely and well after the person they care for is discharged from hospital.
• Most carers (60%) say they receive insufficient support to protect the health and wellbeing of the patient or their own health at the point of hospital discharge.

The Government’s own impact assessment of the Bill recognises that some carers may be asked to take on additional hours of care that could mean they have to reduce their hours or give up work to care. It states: “Whilst we anticipate that in some situations carers may choose to, there is an expectation that unpaid carers might need to allocate more time to care for patients who are discharged from hospital earlier. For some, this could require a reduction in work hours and associated financial costs.”^[2]

The amendment, which is led by Baroness Pitkeathley, has cross-party support, from Lord Young, and Baroness Meacher.  It seeks to place a duty on the NHS Trust to ensure that carers are consulted and to check that they are willing

and able to care, as well as ensuring that the patient is safe to discharge, not just “medically fit” to discharge, by putting the right support in place.

An unpaid carer said about their experience of hospital discharge:

“We discovered it (delayed discharge) when they were on hospital transport on the way home - no assessment, no provision of OT equipment or alternative care, literally had to drop everything to get a commode so they could go to the toilet when they got home. This was despite requesting clarity on discharge and how they would meet both carers’ needs two days previously.”

Helen Walker, Chief Executive of Carers UK, said:

“The removal of carers rights at hospital discharge marks the first time the Government is rowing back on the hard fought for rights for carers. It has the potential to increase the pressure on unpaid carers as well as increase the number of readmissions to hospital.

“Government is suggesting that rights in primary legislation will be replaced by statutory guidance, but this is not the same as having concrete rights in legislation.  Two earlier versions of Discharge to Assess guidance failed to even mention carers and refer to the existing legislation that is being repealed. 

“A patient’s care needs don’t just disappear once they have left hospital – their recovery and health in the longer term is in many cases dependent upon the day-to-day support of a family member at home.

“Too often unpaid carers are being cast out of the hospital discharge process when their ongoing support is critical for the patient’s health. It risks patients having to be readmitted to hospital because the right support at home isn’t in place. We can see from carers’ evidence and stories, it can have a catastrophic effect on carers’ health, wellbeing, and work.

“It is not just about the patient’s safety - unpaid carers must have the support services they need to be able to care safely for their relative or close friend.”

Baroness Pitkeathley, said:

“If we want people to recover well at home after a hospital stay, it’s obvious that carers need to be involved in the hospital discharge process. Research from Carers UK and others has shown too many carers did not have the necessary information or contact details after the person they care for left hospital.  Having to provide more care impacts on their health, wellbeing, family, and many have to give up work to care.

“This amendment is essential to ensure that carers, of all ages, including young carers, are not overlooked in the hospital discharge process and have concrete rights and recognition in legislation.

“This is not the time to take away carers’ rights when we have relied on unpaid carers throughout the pandemic to take on more hours of care to support our health and care systems. Carers already feel invisible in this process when in fact they are partners in care and should be treated as such.

“If the Health and Care Bill passes as is, it will be a major watering down of carers’ rights by the Government and a risk to patient safety.”

^[1] Carers UK 2021 ‘Carers experiences of hospital discharge – Discharge to Assess

^[2] Health and Care Bill- Impact assessments for Adult Social Care Provisions (published 10.01.22)