Quality standard

Quality statement 1: Discharge planning

Quality statement 1: Discharge planning

Quality statement

Parents or carers of a preterm baby have an agreed discharge plan.

Rationale

Many families can feel ill-equipped to care for their preterm baby after discharge, and they may experience high levels of anxiety after leaving the hospital. Involving families in planning discharge and agreeing a written discharge plan can minimise this and help them to feel prepared.

Quality measures

Structure

Evidence of local arrangements for healthcare professionals to agree a discharge plan with parents or carers of a preterm baby before the baby is discharged from hospital.

Data source: Local data collection, for example, service protocols.

Process

Proportion of preterm babies discharged from hospital whose parents or carers have a discharge plan.

Numerator – the number in the denominator whose parents or carers have a discharge plan.

Denominator – the number of preterm babies discharged from hospital.

Data source: Local data collection, such as the child's personal folder or patient record systems.

Outcome

Proportion of parents or carers who felt prepared for their baby's discharge from hospital.

Data source: Local data collection, for example, parent or carer surveys. The Picker Institute's Neonatal Survey 2014 includes a question on whether parents felt prepared for their baby's discharge from neonatal care.

What the quality statement means for different audiences

Service providers (neonatal and postnatal services) ensure that healthcare professionals have the time and resources to involve parents or carers of a preterm baby in discharge planning and provide them with tailored information before the baby is discharged from hospital.

Healthcare professionals (such as midwives, neonatal nurses and neonatologists) involve parents or carers of a preterm baby in discharge planning as soon as possible after the birth of the baby and at all stages. They agree a discharge plan with them that includes information tailored to their individual circumstances. It should cover risk factors for developmental problems and disorders, support available and follow-up arrangements. They share the written discharge plan with parents or carers before they leave hospital and with primary and secondary healthcare teams.

Commissioners (NHS England and clinical commissioning groups) ensure that they commission services that have the capacity and resources to involve parents or carers of a preterm baby in discharge planning and provide a written plan that includes information tailored to their individual circumstances. They undertake contract monitoring and seek evidence that service providers have this in place.

Parents or carers of a preterm baby are involved in planning for going home from hospital as soon as possible after the birth of the baby and at all stages. They agree a written discharge plan that includes tailored information on risk factors for developmental problems and disorders, support available and follow-up arrangements.

Definitions of terms used in this quality statement

Preterm baby

Babies born before 37+0 weeks of pregnancy.

[NICE's guideline on developmental follow-up of children and young people born preterm]

Discharge plan

The plan should include clear information that is tailored to individual circumstances about:

  • any antenatal and perinatal risk factors for developmental problems and disorders

  • routine postnatal care and support available, as described in the NICE guideline on postnatal care

  • universal services and national recommendations for assessing the development of all children through screening (for example, newborn hearing screening) and surveillance (including social, emotional, behavioural and language development)

  • whether their baby will also be offered enhanced developmental support and surveillance and plans for follow-up

  • opportunities for peer support

  • signposting to local support services, such as Bliss, Twins Trust, Scope and National Childbirth Trust

  • talking to their health visitor or GP if they have any concerns about their child's development at any stage of childhood or adolescence.

[Adapted from NICE's guideline on developmental follow-up of children and young people born preterm, recommendations 1.1.3, 1.1.6, 1.1.8, 1.1.11, 1.1.12, and 1.1.14]

Equality and diversity considerations

People should be provided with information that they can easily read and understand themselves, or with support, so they can communicate effectively with health and social care services. Information should be in a format that suits their needs and preferences. It should be accessible to people who do not speak or read English, and it should be culturally appropriate and age appropriate. People should have access to an interpreter or advocate if needed.

For people with additional needs related to a disability, impairment or sensory loss, information should be provided as set out in NHS England's Accessible Information Standard.