Tag Archives: patient experience

Hospital Carer Discharge Meeting – November Update 2025

Chaired by: Matthew McKenzie – Lived Experience Carer

Welcome to the November 2025 update of the Hosptial Carer discharge group. The Hospital Carer Discharge Group is a collaborative network chaired by lived-experience carer Matthew McKenzie, bringing together unpaid carers, carer-centre teams, hospital staff and local authority representatives to improve how carers are identified, supported and involved throughout a patient’s hospital journey.

The group provides a space to share updates from hospitals and carers’ organisations, highlight challenges in discharge processes, strengthen links between community and acute services, and promote consistent carer-focused practices such as using the Carers Hospital Discharge Toolkit, developing standard operating procedures, and raising staff awareness.

The November meeting focused updates from the South East London Carer Standard Operating Procedure pilot, improving carer identification, strengthening links between community and hospital services, and practical challenges in engaging hospital teams.

For those who don’t know, In the context of the Hospital Carer Discharge an SOP is a step-by-step, structured process that hospital staff follow to ensure unpaid carers are identified, informed, supported and included consistently during a patient’s hospital stay and discharge.

It usually outlines:

How to record, communicate and follow up on carer involvement
Who is responsible at each stage (nurses, discharge teams, carer services)
What actions must be taken (e.g., asking about caring roles, sharing information, making referrals)
When these actions should happen (admission, treatment phase, discharge planning)

Who Attended

The session was well attended by a mix of carers, hospital representatives, and carer-centre staff, including:

Carer representatives

Matthew McKenzie – Chair; lived experience mental health carer; Carers UK, Carers Trust & NHS England Citizens Advisory Group volunteer.
Caroline – Lewisham carer, Healthwatch Lewisham member & Patient Experience Committee representative.
Various peer supporters, carers involved in local networks and PPGs.

Carer support organisations

Carers Hub Lambeth
Tower Hamlets Carer Centre
Wandsworth Carer Centre
North Central London Carers Support Project

Apologies

Sutton Carers Centre
Richmond Carers Centre
Greenwich Carers Centre
Harrow Carers Centre
Bromley Well
IMAGO – Lewisham carers Centre
Bexley Carers Support
Involve Kent

Hospitals & NHS staff

Queen Elizabeth Hospital (Lewisham & Greenwich NHS Trust)
Public Service Consultants (PSC)
Bromley, Lambeth, Lewisham, Greenwich council leads (mentioned in discussion)
St George’s Hospital (GESH) – references to staff

Meeting Overview

The growing importance of carer involvement in hospitals, especially with mental health pressures and changes to the Mental Health Act.
The group’s purpose: sharing updates, strengthening links between carers and hospitals, and improving the implementation of the Carers Hospital Discharge Toolkit.

Key Presentation – Update on the South East London Carer SOP Pilot

Speaker: Public Service Consultants (PSC)

The major portion of the meeting focused on the pilot testing of a new 11-step Standard Operating Procedure for identifying and supporting unpaid carers across hospitals in South East London.

🔹 Hospitals involved in the SOP pilot

King’s College Hospital – Acute Medicine ward
University Hospital Lewisham – Hawthorne (older patients) and Alder (specialty medicine) wards
Princess Royal University Hospital (Bromley) – Frailty Unit via Transfer of Care Hub

🔹 Key outcomes

King’s College Hospital saw the strongest progress.
- Nurses proactively engaged unpaid carers.
- All leaflets and materials were distributed within weeks.
- Carer details (with consent) were passed to Lambeth Carers Hub.
- Nursing staff requested feedback loops to see the impact of referrals.
Lewisham Hospital
- Progress slower initially; improved after site visits.
- Ward managers highly supportive and embedding SOP practices.
- Lewisham Council exploring funding for an in-hospital carers support team.
Princess Royal (Bromley)
- SOP and leaflets now shared with the frailty unit.
- Council to continue taking work forward.

🔹 Overall reflections

Hospitals still experience heavy winter pressures and staff capacity issues.
Engagement differs widely between NHS trusts.
Many ward teams had never seen the London Carers Toolkit, indicating a need for simplification.
Councils intend to continue cross-borough meetings after PSC’s involvement ends.

Issues & Discussion Points

1. Gaps in consistency across hospital sites

Queen Elizabeth Hospital (QEH) had not been part of the pilot, they have requested to be included
Staff expressed interest in adopting SOP materials and joining future rollout.

2. Carer diversity and training needs

Caroline highlighted the need for:

Training reflecting different care needs: LD, dementia, mental health, elderly carers.
Cultural diversity considerations in how carers interact with hospital teams.
Better alignment with Lewisham & Greenwich’s Compassion in Care programme.

3. Current SOP scope limitations

SOP starts at the ward stage, but carers need involvement pre-admission and post-discharge.
Best practice from NICE and the national toolkit emphasises whole-journey support.

4. Hospital culture & resistance

Carer-centre staff described feeling:

Like a “hindrance” in MDT or discharge meetings
Sometimes unwelcome or blocked from engaging on wards
Fighting clinical priorities vs. carer rights
Still needing major awareness-raising to reduce resistance

A carer noted power imbalances and the risk that carers are seen as “barriers to discharge” rather than essential partners.

Updates from Carer Centres & Hospital Teams

Carers Hub Lambeth

Significant increase in referrals, especially from King’s.
Engagement seems weaker at Guy’s & St Thomas’, it looks to be still pushing for a stronger carers strategy there, but hopeful the strategy should pick up.
Working with ward rounds and direct conversations with carers.

North Central London Carers Project

Working across 8 hospital sites, possilbly

Royal Free Hospital
Barnet Hospital
North Middlesex Hospital
Chase Farm Hospital
The Whittington Hospital
University College Hospital
St Pancras Rehabilitation (Camden and West London)
Community Central London Trust
North London Foundation Trust (Mental Health)

Updates include:

A hospital “menu” to track progress across the toolkit (training, comms, discharge planning).
Embedding carers into induction programmes.
Co-authoring discharge documentation at St Pancras Rehab Centre with dedicated “carer sections”.
Upcoming use of Cerner electronic records system to automatically flag carers.

Tower Hamlets Carer Centre

Carer representative based at Royal London Hospital (east London)

Challenges include:

Slow referrals & reliance on staff awareness
Some carers only identified at crisis stage
Need to expand the carers passport across Royal London
Hackney pilot ends in March concerns about future funding

Wandsworth Carer Centre / St George’s

Developing carer awareness training with Patient Experience Team
Growth in referrals after training sessions, though staff forget over time
Plan to expand ward coverage
As chair I shared St George’s new Carers Charter as a tool for accountability

Carer-Led Developments in Primary Care

A group of Lewisham unpaid carers has begun major work with GP practices, including:

Creating a PCN-wide carers information pack
Ensuring carer champions in GP surgeries
Working with pharmacies to distribute information
Improving identification on GP systems
Exploring alignment with Lewisham’s new Carers Action Plan

Plans for the Future

More invitations to NHS carer strategy leads
Sharing SOP materials with non-pilot hospitals where possible.
Matthew to link contacts across councils and hospitals for ongoing monitoring, being the following boroughs e.g.

Lewisham

Assistant Director – Adult Mental Health & Wellbeing
Joint Commissioner – Adult Mental Health & Wellbeing

Greenwich

Strategic Commissioning Lead
Commissioning Lead for Carers

Bromley

Assistant Director – Commissioning
Commissioning Officer

Bexley

Service Manager – Adult Social Care

Lambeth

Integrated Commissioning Manager – Adults and Health

Southwark

Strategic Programmes Manager
Commissioning Manager

Medium-term aims

Push for in-hospital carer support teams in Lewisham & Greenwich.
Expand training and embed carers into staff induction.
Improve pre-admission and discharge-planning pathways on carer identification and involvement for familes and carers.
Stronger collaboration between LD nurses, dementia teams, and carers services.

Longer-term aspirations

Greater consistency across trusts
Unified carers strategy within each hospital
A system where carers are routinely recognised, supported, and involved in decisions

Closing Remarks

As cchair I closed the meeting by thanking attendees and acknowledging the collective effort to improve carers’ experiences across London hospitals. I reaffirmed the importance of:

Making carers visible
Ensuring rights are upheld
Strengthening trust–carer relationships
Carrying learning into the new year

The next meeting will be scheduled in January, with hopes of smoother cross-hospital collaboration in 2024.

SW London Carers Forum – November 2025 Update

By Matthew McKenzie, Co-Facilitator – SW London Carers Forum

About the South West London Carers Group

The South West London Carers Group brings together unpaid mental health carers from across the boroughs of Sutton, Merton, Wandsworth, Richmond and Kingston, to share experiences, gain peer support, and stay informed about local health and social care developments.

The group provides a safe and welcoming space where carers can discuss the challenges of supporting loved ones particularly those with long-term conditions or mental health needs while also learning from guest speakers, professionals, and each other. Co-facilitated by myself, the forum plays an important role in making carers’ voices heard and strengthening connections between carers and local NHS, mental health, and community services.

Our November South West London Carers Group meeting brought one of the most informative sessions we’ve had all year. We were joined by Dalvinder, the Patient Experience Lead for NHS 111, who provided a thorough and eye-opening look at how the 111 urgent care service really works, what carers can expect, and how the system is evolving.

Dal’s role involves reviewing patient feedback, monitoring the quality of calls, and ensuring that the service remains compassionate, safe, and responsive. He also regularly meets with community groups, like ours to raise awareness of what 111 can offer.

24/7 Telephone Assessments

Dal opened by reminding us that NHS 111 operates 24 hours a day, 365 days a year, and never closes. The telephone assessment is often the first point of contact, and callers speak to a trained health advisor who uses the NHS Pathways system to ask structured questions. This ensures the call handler can rule out serious issues and direct the caller to the right service quickly. Dal emphasised that while questions can feel detailed or repetitive, each answer opens or closes clinical “pathways,” helping the system determine the safest next step.

GP Home Visiting (Evenings, Overnights, Weekends)

One of the biggest surprises for many carers was learning that NHS 111 has a GP home visiting service, specifically for times when GP surgeries are closed weekday evenings, overnight, weekends, and bank holidays. This service is intended for people who cannot safely travel, including those with mobility issues, caring responsibilities, or urgent health needs that don’t require hospital care. If a home visit is determined to be appropriate, a GP working for 111 can visit in a dedicated GP car and may provide medication on the spot or issue prescriptions if needed.

Primary Care Clinics (PCCs) – Same-Day Appointments via 111

Dal also explained the role of Primary Care Clinics (PCCs) located across South West London. These clinics operate outside normal GP hours and can see patients the same day—but crucially, access is by 111 referral only. If 111 decides that someone needs to see a GP face-to-face and can travel, they may be booked into a PCC appointment. Carers learned that you cannot walk into these clinics directly; 111 must assess the situation and confirm the appointment. This helps manage demand and ensures that appointments go to those who need them most urgently.

The Expanding Role of Pharmacies and “Pharmacy First”

Another major theme was the evolving role of pharmacies in urgent care. Dal explained that pharmacists are highly trained professionals—more trained than many realise—and 111 can now direct callers to pharmacists for assessments, repeat prescriptions, and urgent medication needs. The Pharmacy First scheme allows some pharmacies to provide consultations and treatment in private rooms for a range of minor illnesses. 111 can also arrange emergency prescription access if someone runs out of routine medication while travelling, provided the medication is part of their regular treatment.

Arranging Call-Backs From Your Own GP

In certain situations, NHS 111 can request that your own GP practice contacts you, especially for non-face-to-face issues such as renewal of regular medication, questions about paperwork, or administrative needs. While GP appointment slots reserved for 111 are limited and fill quickly, the service can still send urgent notifications to GP surgeries when clinically necessary. Dal encouraged carers to mention when the need is time-sensitive so the system can prioritise appropriately.

Mental Health Support via 111 Option 2

One of the most important updates for mental health carers was the introduction of 111 Option 2, currently being trialled across London. When callers choose this option, the call is diverted away from standard 111 and straight to local specialist mental health teams, who can assess issues such as relapse, agitation, distress, changes in behaviour, or crises at home. Dal emphasised that while 111 is not a specialist mental health service, Option 2 ensures that people with mental health needs receive expert support. Data from the pilot is expected next year, and Dal offered to return to share the outcomes.

What We Learned About NHS 111

Many carers know the NHS 111 number exists, but few realise the range of services behind it. Dal explained that 111 is a free, 24/7 service (including weekends and holidays) designed for urgent health concerns that are not life-threatening.

Many carers commented that they had no idea 111 provided such a broad range of services.

Questions From Carers

Carers asked many thoughtful and practical questions during the session, including:

1. Mental Health Crises

A carer asked how 111 responds to mental health emergencies, particularly when someone becomes distressed, unwell, or difficult to support at home.

Dal explained that 111 itself is a generic urgent care service, but Option 2 sends callers straight to trained mental health professionals, who can triage cases such as relapse, agitation, or risk concerns in a more specialist way.

2. Access to Medical Records

A question was raised about whether 111’s clinicians can view a patient’s medical history.

Dal clarified that clinicians have access to the Summary Care Record, containing essential medical information, medications, conditions, and recent interactions—if the caller gives consent.

3. Home Visiting Times and Coverage

Carers asked about response times and geographical limits.

Dal explained that SW London is fully covered, though travel times vary depending on the area and how busy the service is. Home visiting is evenings, nights, and weekends only.

4. Staffing Levels and Training

One question focused on whether call handlers are medically trained.

Dal shared that 111 employs 180 health advisors in SW London—non-clinical staff who have completed an intensive six-week training program. They follow the NHS Pathways system and are supported by clinical advisors (GPs, nurses, paramedics) who can join or take over calls when needed.

5. Using 111 When Travelling

A carer asked about getting medication while away from home.

Dal explained that 111 can arrange for prescription collections at pharmacies in another part of England, which has helped many travellers who forget medication.

6. Hearing Impairment and Accessibility

There was interest in support for people who cannot make phone calls.

Dal confirmed services such as text relay, online 111, and the NHS App, all of which improve accessibility for carers and patients with additional needs.

Carer Reflections and Experiences

Several carers shared personal experiences both positive and challenging. One described how 111 triage was vital when they urgently needed treatment for a severe infection, while another discussed difficulties when GP surgeries didn’t always respond quickly to reports sent by 111.
These real stories helped emphasise how important it is for carers to know when and how to use the service, and how essential accurate information is during triage.

Key Tips Dal Shared for Carers

Give as much information as possible, including social factors such as caring responsibilities, mobility challenges, or inability to travel.
Stay with the person you’re calling about, as the call handler will ask you to check symptoms in real time.
Tell 111 if symptoms change—this can alter the urgency and outcome.
Always keep your phone nearby when waiting for a callback; 111 will try only three times.
Don’t hesitate to call again if you’re unsure or worried.

Closing Thoughts

The session was incredibly well-received. Many carers said they learned things they never knew, even though they had used 111 before. Dal’s openness and honesty—both about what the service can do and what its limitations are—made his presentation especially valuable.

As co-facilitator, I (Matthew McKenzie) will continue to share information like this to help carers navigate local health services more confidently. We hope to invite Dal back once the evaluation of 111 Option 2 (mental health) is published, we also have a keen interest on what the ICB is doing especially regarding carer involvement.

Hospital Carers Discharge toolkit Meeting Update September 2025

By Matthew McKenzie – Carer activist

London Carer Organizations Network Update

The meeting focused on introductions and updates from various organizations supporting unpaid carers across London. Matthew McKenzie facilitated the session, introducing participants from different boroughs and organizations, including

NHS England
Healthwatch (local advisory committee involvement)
North Central London Carer Support Project (covering Barnet, Haringey, Camden, Enfield, and Islington)
The PSE (supporting South East London local authorities: Bexley, Bromley, Lambeth, Lewisham, Greenwich, and Southwark)
Richmond Borough Mind
Richmond Carers Centre
Kingston Carers Network
St George’s, Epsom and St Helier Hospital Group
Sutton Carers Centre
Carers Hub Lambeth (supporting unpaid carers, with hospital carers leads at King’s College Hospital and Guy’s & St Thomas’ Hospital)
Lewisham carers services (Imargo service manager)

Apologies from

Bromley Wells
Bexley Carers Support
Greenwich Carers
Ealing Carers Partnership
Tower Hamlets Carers Centre

NHS England updates including Universal Care Plan Updates

A representative from NHS England highlighted good news about the Hospital Discharge Toolkit, which had been originally developed in London by Debbie Hustings. The toolkit has already been adopted across much of southwest London with strong results. Recently, all NHS regions were asked to contribute work on hospital discharge, focusing particularly on carers’ experiences. When this went up to the Executive Quality Board at the national level, the London toolkit received recognition. The recommendation that came back was that all regions should develop something similar they could adopt London’s version directly or tailor one for their own needs. The representative stressed that this kind of recognition is significant because it helps the toolkit be taken more seriously and provides momentum for further rollout

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My Review on Healthwatch Southwark – 1 Year on event

I thought this time I would do a post on an healthwatch event. Now I have done some posts about healthwatch before, sometimes Healthwatch Lewisham and other times Lambeth, but this time I was over in the London borough of Southwark for the Healthwatch Southwark event – One Year on.

Before I continue on how the event went, what is healthwatch Southwark all about? Well basically taken from their site – Healthwatch gives people a POWERFUL voice locally and nationally on matters concerning health services. At a local level, local Healthwatch will work to help local people get the best out of their local health and social care services. Whether it’s improving them today or helping to shape them for tomorrow.

Now there are healthwatches across different boroughs of London and the UK, all giving people the chance to form an opinion of the health services. Healthwatch does more than just listen and engage, they also do enter and view of health services and produce many reports. So the thing is what has Healthwatch Southwark been up to over the year they have been in action?

Well on the 22nd of November, I took a trip over to Pembroke House over in Southwark and was greeted friendly by the healthwatch staff and a staff member of “Community Action Southwark”. As a reminder, the Healthwatches are heavily volunteer focused and depend on involvement by the community, especially by those who have a passion for improving or championing the health service in the UK.

When I entered the premises, I was glad to see quite a few stalls on display, although one of my main interest was the stall about mental health awareness and engagement. I took the opportunity to visit the CoolTan Wellbeing stall. CoolTan Arts exists to inspire and transform peoples lives though creativity and self-advocacy. The stall advertised the up and coming CoolTan Coolwalks, which I have been on several times. The stall also had booklets and information about mental health and a video about different periods the coolwalks focused on.

The next stall I visited was a stall promoting sexual health research and awareness, which is one of Southwark Healthwatch’s main area on raising awareness about sexual Health. I spoke to the stall holder about her research and its main aim is to have people from the area of Lambeth & Southwark from aged 16-30 be part of an innovative sexual health study, where people can look to getting a sexual health check and tell them what they think about the service. Getting tested on sexual health is very important for many reasons.

Soon I spoke to the stall holders of the Southwark & Lambeth Integrated care where Health and social care organisations and people in Southwark and Lambeth have come together so that local people can lead healthier and happier lives. I was impressed by their display and the stall holders explained some important reasons for building a community along the lines of better healthcare. They want people to at least

– Feel they are a part of the community
– Have systems in place so they can avoid having a crisis at a later stage
– Live independently
– For carers to live the life they want to the best of their ability.
– and lots more

Another stall I visited was the Southwark CCG stall, where they had lots of interesting information on what Southwark Doctors have been doing to improve healthcare for the borough. The CCG stands for Clinical Commissioning Group, which basically means a membership organisation of all the GP surgeries in a borough who help organise the delivery of NHS services. One of the main focus of the CCG is of the commissioning of services hence where should the money be allocated to on providers of health services.

My main interest was the Southwark CCG summary annual report for 2013-14. I also picked up and took away people’s health information is used in the borough of southwark. I urge those interested in their health and health services to read up on such information when they can.

I also noticed stalls doing free health checks, free eye check examinations and I was also given a free health goodie bag. I guess Xmas has come early for me.

After having some tasty lunch, which was provided free of charge by Healthwatch Southwark. We then went upstairs for the main event. The event was to hear what has healthwatch Southwark been up to? It was time to hear their story.

First to speak was Southwark Healthwatch Chair David Cooper. David spoke on the following being how much work and effort HW Southwark has been doing, The new NHS 5 year plan in south london, how financially difficult it has been for the health services and the importance of Healthwatch Southwark.

David then moved on to the agenda of today’s speakers, which I was keen to hear from.

We were then introduced to the new Healthwatch Southwark Manager Aarti Gandesha, now Aarti spoke about more about Healthwatch Southwark’s aims as you can see from the picture. She also talked about how people can get involved with healthwatch and there are many ways to get involved if you are passionate about your health services.

Aarti then talked about what HW Southwark has been up to so far and many of their engagements have been on the community focus groups involving different members of Southwark’s communities. Healthwatch Southwark have also held many public forum events and community events. Plus HW Southwark have been busy collecting stories for their joint ‘1000 lives’ project.

The Healthwatch Manager then moved on to explain what Healthwatch priorities are for Southwark and there are 4 being

1. Access to GP Services
2. Access to Mental Health Services (my main area of interest)
3. Sexual Health Services
4. Social care Services

Next Aarti talked about Healthwatch Southwark’s archievements during the past year where they have

– Engaged with a large number of people over group sessions
– Established 4 priority areas
– have 676 supporters
– received 194 info and signposting queries
– and more

After Aarti’s presentation and talk, we then got to hear a story from a carer in the borough of Southwark. The story resonated similar themes that I go through as a carer e.g. the worry of services being closed down, being able to relate to others, the hope that things will get better and having to provide advice for others.

We then got to hear a talk and presentation from Southwark CCG Director Paul Jenkins. Now Paul’s talk was on the current & Future Opportunities for locality and neighbourhood working. Paul talked about understanding Southwark’s population and health needs (shown as a tree in picture).

Plus Paul talked about the direction of travel when people needed to access health services in Southwark. The aim was to look into providing GP practices that will work closer together in the borough, plus providing a wider range of hospital care closer to patients homes. The thing I noticed from Paul’s talk is that services will need to work together since there will be many challenges.

We were shown the different neighbourhood groups of practices and their reach into the community. Plus the explanation of the direction of travel where many schemes and projects will be set with the aim of GPs working together

The last speaker was Kerry Crichlow who is Southwark Councils director of strategy and commissioning. Her talk was about health and social care commissioning and the integration in the borough of Southwark.

Kerry gave a quick run down on the big issues about commissioning. Those being an ageing population and responding to financial challenges, plus health inequalities. Next Kerry moved onto opportunities where a strategy developed to aid the patient’s journey through their experiences in health. Plus building a stronger framework on prevention and inclusion. Kerry spoke more about the opportunities to shape provisioning around people and maximising integration of health services.

After the presentations, the public and patients who attended got to ask some quick questions, I won’t go into the answers, but some questions were based on

What can be of assistance for those who have physical disabilities or those who have hearing impairment?
What can bridge the divide in health equalities in the borough of Southwark?
How can personalisation help those who have had bad experiences health assessment?

The next and last stage of the event was people to seperate into groups and provide HW Southwark and their facilitators opinions on the following

1 – Service Changes
2 – HW Priorities
3 – Involvement in HW Southwark

The one I chose was the “Involvement” table on how can Healthwatch get more people to volunteer. Each person on our table talked about their role and connections and we also talked about who do each of us talk to when we experience good or bad things in health service. Usually it would be our friends, family or specific groups. For me I tend to speak about my experiences at a carer’s group.

We also discussed the importance of social media, which is one of my area of expertise and also the purpose of volunteering since some would like to volunteer, but are not sure how much work it would involve.

After feedback from each table. David then thanked all for attending. I was particularly glad I attended the event and was allowed to even blog the event. What I got most off this event is learning more about Southwark’s Health and social care setting, learning even more about Healthwatch, networking as I got access to sit on more groups and also giving my opinions.

Thanks for reading my blog post of this event.