Report: Bridging the Gap - Substance use, discharge and what comes next
People from across Swindon told us that the current discharge process often does not meet the needs of those dealing with substance use, withdrawal, trauma, or difficult social circumstances.
Gaps in communication, stigma, and rigid clinical processes can lead to avoidable harm, people leaving hospital early, and repeated crisis admissions. Staff accounts closely matched what service users described.
Our goal for this project is reflected in the recommendations we have made to local services: to make hospital discharge safer and more supportive for patients.
Download our full report below.
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Across interviews and workshops, service users and professionals suggested discharge was a critical point in a patients care journey but shared how it commonly breaks down.
Experiences were characterised by abrupt decision‑making, limited planning, and an absence of coordination. These patterns created transitions that felt unsafe, poorly communicated, and disconnected from the realities of substance use, withdrawal, and social vulnerability.
No one asks what I need; I just wanted someone to check on me and ask if I’m ok.
Our CEO, Kevin Peltonen-Messenger said:
"What these people shared with us was honest and, at times, deeply unsettling. Discharge was often described as rushed, confusing and poorly coordinated particularly when it came to medication, follow‑up care and basic practical support.
"Experiences of stigma, judgement and inconsistent communication were common, leaving many reluctant to seek help again, even when seriously unwell. Yet alongside this, people also told us about moments of compassion, flexibility and kindness. These are reminders that safer, more humane care is not only possible, but already happening in pockets of the system.
"This report is not about blaming individuals or services working under immense pressure. Instead, it highlights how systemic gaps in communication, coordination and accountability can create avoidable harm for people with complex needs. It makes clear that discharge is not a single event, but a process – one that requires shared responsibility, trauma‑informed practice, continuity of medication and meaningful follow‑up."
