Follow up of patients
A proactive system for following up patients shortly after discharge would not only be good "customer service", it would probably provide a wider range of responses and feedback on their care.
- There is no national mandatory requirement for hospitals to contact patients after discharge to check on outcomes or experience. Government hospital discharge guidance focuses on the discharge process itself, including needs assessment and transfer of care, but does not mandate post-discharge follow-up contact by the discharging hospital (Hospital Discharge and Community Support Guidance, DHSC, 2022).
- Some trusts operate post-discharge phone call schemes as local good practice — for example, 24-hour post-discharge phone calls — but these are voluntary initiatives, not national requirements. NHS England has published case studies of such schemes to encourage adoption (NHS England, Post-Discharge Phone Calls Case Study).
- Healthwatch, in its November 2023 position on safe hospital discharge, called for "new minimum standards on post-discharge contact times to be included in updated guidance," indicating that such standards do not currently exist (Healthwatch, Our Position on Safe Hospital Discharge, November 2023).
- The Friends and Family Test captures some post-discharge feedback, but this is a general experience survey rather than the proactive clinical follow-up system Francis recommended to check patient wellbeing and identify problems after discharge.
How was this evidence gathered?
Response
Accepted
Response
AcceptedThe government published "Hard Truths: the Journey to Putting Patients First" (Cm 8777) on 19 November 2013, responding to all 290 recommendations of the Francis Report. This followed an initial response "Patients First and Foremost" in March 2013. Key reforms included a new Chief Inspector of Hospitals, strengthened Care Quality Commission inspection regime, a statutory duty of candour, and the fit and proper person test for NHS directors. Volume 2 (Cm 8754) contains the government's detailed responses to each of the 290 recommendations. See: https://assets.publishing.service.gov.uk/media/5a7cd486ed915d63cc65d167/34658_Cm_8777_Vol_1_accessible.pdf
Published Evidence
Published assessments of progress from inspectorates, select committees, official progress reports, and other sources. Source type badge indicates whether each assessment is independent or government self-reported.
Francis recommended systematic follow-up of patients after discharge. NHS trusts have improved discharge planning and some follow-up mechanisms exist. However, pressures on community and primary care services mean systematic post-discharge follow-up remains inconsistent, particularly for elderly patients -- the group most at risk in the Mid Staffs scandal.
View detailed findings
Discharge planning improved but systematic follow-up remains inconsistent, particularly for elderly patients.
Research published 2023 marking ten years since the Francis Report found mixed results. Structural and legislative changes largely delivered (duty of candour, FPPR, CQC overhaul, revalidation, Freedom to Speak Up Guardians). However, cultural change not fully embedded; understaffing, fear of speaking up, and poor complaint handling persist in parts of the NHS.
Government published "Culture Change in the NHS" (Cm 9009) reporting progress on all 290 recommendations. Key achievements: 19 hospitals placed in special measures; those trusts recruited 109 additional doctors and 1,805 additional nurses; 129 board-level changes made; excess avoidable deaths fell by 450 in less than a year.
Government published "Hard Truths: The Journey to Putting Patients First" (Cm 8777) in two volumes. Vol 1 set out new actions; Vol 2 provided detailed response to each of the 290 recommendations. Approximately 204 of 290 recommendations were fully accepted.