14 Feb Co-production here in plain sight: rethinking hospital discharge

Hospital discharge for older patients is often described as a system that isn’t working. Our research reveals it is not just a system problem but a human one, demanding human-driven solutions. We explored this by interviewing patients in hospital on their day of discharge and following up with them at home to compare their expectations with reality.

What emerged was that families and friends are already co-producing vital parts of discharge process. They act as informal care coordinators—ordering equipment, arranging home repairs, and navigating social care. Yet they have far less information available to them than health and care professionals, making their task harder than it needs to be. While hospital staff can quickly access a patient’s record, family members must chase multiple professionals for updates.

One participant, “Pete,” was hospitalised with a suspected bladder infection. His legal next of kin “Steven”, managed everything from liaising with the housing association about a broken window to advocating for a more thorough assessment of Pete’s cognitive health. Despite these responsibilities, Steven had little clarity from hospital and community health professionals about Pete’s condition or the next steps and was constantly chasing information so that he could make the right arrangements and fill gaps.

Our key finding from this work is that family and community networks are integral to a successful discharge, yet they often operate in the dark. This gap can lead to confusion, compromise patient wellbeing, and increase the risk of avoidable re-admission. At a time when many professionals and sector leaders are searching for models of co-production in health and care – it is right here in plain sight, yet it is not always recognised or embraced.

Encouragingly, the partnership that commissioned this research is now using our research to inform a multi-agency change project. They are improving patient information, introducing new roles to provide discharge advice, and coordinating more closely with family members. These steps recognise that many of the problems in the discharge process can be overcome when the role of families and friends is supported through systems which embrace co-production.

You can read the final report of this work here. If you’d like us to present these findings to your team or discuss conducting similar research with your own local health and care users please get in touch with Ben.lee@sharedintelligence.net