"Why can't there be senior nurse led discharges in such situations?"

My routine surgical procedure went well and I stayed 2 nights in Firth 4. The nursing care at all levels from healthcare assistant to sister (and especially the three staff nurses responsible for my day and night care during the period) was very good - consistent, responsive, kind and efficient. A difficult situation on the ward because of the condition of one of the patients was managed well with proper attention to dignity and an extra support system at night. The ward environment and caretaking was also good. Overall it was a big improvement on a stay I had in one of the Huntsman wards five years ago.

However the discharge procedure has not improved. My discharge was agreed with a consultant at 9.00 am, but the written procedure did not even start until 4pm when I was told that my prescription had not yet even been ordered from the dispensary and could take 2 or 3 hours. Since 2 of them were common OTC drugs and I wasn't sure I wanted the third, I took an agreed discharge without waiting, with details of what I would have been prescribed. Another patient was deciding to do the same.

Exactly the same happened in my previous stay and it was a similar story when my wife was discharged from the Hallamshire last year - waiting a whole day for a physio to take her up and down one flight of stairs when she was easily mobile enough - this in a Trust which sometimes has difficulty in meeting its A&E target and complains of bedblockers.

What seems to happen is that the moment that a routine discharge is agreed it slips right down the priority list, especially if the duty junior has urgent cases to deal with and does not get round to the paperwork until the end of the day. Why can't there be senior nurse led discharges in such situations?