Communication between teams and information sharing
Our casework also identified communication failings between various teams involved in the care of a patient. These include delays in decision-making about treatment or next steps, leaving patients and families confused and constantly having to chase for updates.
Patients receiving end of life care often move across settings, for example, between wards, or to a hospice or care home. If information does not follow the patient effectively, it can inhibit continuity of care.
In one case, we found a Trust inappropriately discharged a patient to a nursing home. The home was not briefed properly on the patient’s condition and was not equipped to provide the level of care he needed. As he was approaching the end of life, this was a missed opportunity to manage his symptoms better and lessen his suffering.
Our investigations have highlighted communication failings at a system level. We have found that there is unclear ownership of information and a lack of reliable mechanisms to make sure that critical information follows a patient to support continuity of care. This lack of coordination between services creates distressing circumstances for patients and their families.