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In focus . . . The main entrance at Timaru Hospital. PHOTO: CHRIS TOBIN

by Chris Tobin

South Canterbury District Health Board says its discharge system for patients is working in most cases and they are not pushing patients out of hospital without following a discharge plan.

“There’s always room for improvement but I think for the majority of patients, it’s going well,” SCDHB chief medical officer primary health Bruce Small said.

There has been recent negative publicity about the manner in which two patients were discharged from Timaru Hospital.

Dr Small said they dealt with a whole spectrum of patients, from those who might come for a simple procedure to those with major medical problems who were often old and frail which made things more complicated.

Asked to rate how the system was working out of 10, Dr Small replied: “It’s hard to rate it; we’d like it to be 10 but it’s probably eight.

“There is room for improvement which is why it’s good people tell us if anything has gone wrong so we can put things in place in the hope it will be better for the next person.”

Decisions to discharge a patient followed a set procedure in which a checklist had to be completed. On occasion, discharges were brought forward and done more quickly than planned when the hospital was under pressure, Dr Small said.

“Ideally, staff always plan to send patients home as soon as they are close to normal function as possible.

“Some communication [to families] can be done better to understand the process better.

“We’re not always going to get it right and some get the perception their mum is getting chucked out.

“But it is a well-thought-out process.”

One of the recent cases reported by media involved a terminal patient, Philip Wakefield, who was taken by wheelchair taxi from Timaru Hospital to a hospice where he died hours later.

Dr Small said in such cases it came down to the patient and what he or she wanted – to stay in hospital or leave.

“We will do our best to accommodate that. Palliative care specialists and palliative care social workers develop a rapport with patients over time and have a good understanding of what the patient wants.”

However, in Mr Wakefield’s case, the SCDHB admitted to getting it wrong.

SCDHB chief executive Nigel Trainor said the error came in the hospital’s endeavour to meet Mr Wakefield’s wishes to go to a hospice.

Friends of Mr Wakefield, Eric and Barbara Solomon, have since made a formal complaint to the Health and Disability Commissioner.

“Although we have acknowledged and apologised in person and in writing, somehow in our complaints process we have failed to alleviate Mr and Mrs Solomon’s concerns,” Mr Trainor said.

“We don’t want people to feel like their voice has not been heard. And so we welcome this opportunity to understand how we can improve.

“We invite anyone who experiences something that doesn’t feel right, to share their feedback with us so we can work together to achieve an outcome that makes our health system stronger.”

The SCDHB has not received a formal complaint regarding the second reported case.

Renee Templeton, acting director Allied Health, said patients were encouraged to complete an advanced care plan early on to set down their wishes.

“It’s documented and written down and the family can be involved if they wish.”

Dr Small said they made sure the plans were shared with families and encouraged people to speak out.