When do you plan a discharge NHS

Published 31 March 2022
Last updated 1 July 2022 + show all updates

1. 1 July 2022

   Added call-out box to the guidance (PDF and HTML attachment) to explain that Section 91 of the Health and Care Act comes into force on 1 July 2022, introducing a new duty for NHS trusts and foundation trusts to involve patients and carers (including young carers) in discharge planning.

2. 31 March 2022

   First published.

No one enjoys having to stay in hospital and it’s understandable to want to know your discharge date as soon as possible.

But your health and recovery is the priority, so you shouldn’t be discharged until the doctor and team caring for you, decide you no longer need care in an acute hospital.

• When will I be discharged from hospital?
• What will hospital staff do to prepare me for discharge?
• How am I assessed for ongoing support?
• How are my needs for longer term care assessed?
• How is the support I need arranged?
• How can I arrange my own home care?
• What if I need to go into a care home?
• What should I do next?

In the days after your admission, hospital staff should have explained to you that you will be discharged on the day the doctor decides you no longer need hospital care.

During your stay, staff will discuss your discharge with you. However, if you do have ongoing care needs, there will no longer be full care assessments in hospital. Support offered when you leave, will give you a chance to recover further before making any decisions about your long-term care.

You may not need formal care and support when you leave, simply advice or support to arrange help with shopping or domestic tasks for a few weeks.

Here are some of the basic things staff responsible for your discharge should make sure are in place, particularly if you do not need any formal care when you leave hospital:

• you have clothes to go home in and front door keys
• you have enough money for short-term needs
• there’s someone collecting you, or a taxi or hospital transport is booked
• you and where necessary your family carer have a supply of medication to take home and understand any new ones you’ve been given
• you and/or your carer can use any new equipment aids with confidence
• if you need incontinence products, a supply has been arranged
• you know about support available from local organisations if you initially need with tasks such as shopping or collecting prescriptions
• your GP has been informed of your discharge.

The nurse in charge of your ward should explain to you and family carers:

• the criteria the doctor will use when deciding you no longer need to be in hospital,
• where they think you are likely to be able to move to,
• your likely needs at that time
• when they think you will be ready to leave.

Once it’s decided you no longer need to be in hospital, staff are likely to arrange for your discharge to take place the same day.

Many patients don’t need formal care, and only need help at home with domestic tasks for a few weeks.

The NHS has leaflets staff can use when talking to you about your hospital stay, what you can expect if you are to be discharged home or to a residential setting and one to help friends and family who are to provide ongoing care and other support.

But if you do need formal care, you won’t have a detailed assessment in hospital. This will take place wherever it’s decided you should be discharged to, either on the same day or day after. In most cases you are discharged to your own home but it may be to a residential setting such as a community hospital or care home. If you’re going home, hospital staff arrange any immediate care you need once you’re home.

Your care and support plan

Staff will discuss your needs then agree with you a recovery and support plan, which might include any equipment you need or reablement support. This will help you learn or re-learn daily living skills, improve your mobility and re-build confidence you may have lost while unwell.

If your plan includes new care elements, the government will fund your care for up to six weeks.

As well as supporting you to recover further, staff are expected, during the six weeks after you’re discharged, to carry out an assessment of your longer-term ongoing health and care needs, decide how this care will be funded and let you know whether you will need to contribute towards the cost.

If you have a local authority care needs assessment, staff look at your health and care needs, as well as the emotional and social side of your life. For example, you may need help with things like personal care or preparing and eating meals. The aim is to help you to live as independently as possible.

If you have a carer, they are entitled to a separate care assessment and there may be support available for them too.

You may need an assessment for NHS continuing healthcare if staff believe you may be eligible; or a local authority care needs assessment; or in some cases a joint assessment that leads to a decision about your eligibility for NHS continuing healthcare or for local authority support.

If you may be eligible for NHS continuing healthcare, staff must follow the process described in the National Framework for NHS continuing healthcare. If you are found to be eligible, the care you need will be arranged and funded by the NHS.

If you have an assessment from your local authority and they decide you are eligible for support, you’ll also have a financial assessment to see if you’re eligible for financial support too.

If you are eligible for support, staff work with you to decide how best to meet your needs. They give you a written care plan showing what help you’ll get and details of who to contact with any questions or problems. Your local authority will help you arrange services either in your own home or a care home.

The local authority must check the support is still right for you within a reasonable time frame. After this, your care plan should be reviewed at least once a year, or more often if needed.

If, at any time, you find that the support services aren’t suitable, you should contact social services and ask for a review of your care plan.

If you received posthospital support in a residential setting, are eligible for local authority help and able to go back home, staff will make sure support services are ready to start before you leave.

If you have eligible care needs but aren’t eligible for financial support, you must arrange your own services to meet your needs and staff must be sure you’re able to do this.

If you only need help with domestic tasks for a few weeks while you recover, hospital staff may be able to organise this or suggest local organisations that can help.

Your local Age UK and other voluntary organisations may offer ‘home from hospital support’. These services may help to get your home ready for your return and assist with non-medical tasks such as shopping and light housework.

If you have care needs but don’t meet eligibility criteria for local authority support, you should still be given information to help you arrange your own care. If you’re arranging your own care, it’s always a good idea to get costs and an outline of services from several local agencies. When you find one you’re happy with, you can agree a care plan.

If there’s a possibility of you going to live in a care home permanently please read our information explaining the types of care home, paying for a care home, finding a care home and choosing the right one.

1. Review your hospital care plan and keep it in a safe place.
2. Make a list of questions for hospital staff.
3. Organise for someone to pick you up from hospital or check if the hospital can organise for transport.

For more information call the Age UK Advice Line on 0800 678 1602.
We’re open 8am to 7pm, every day of the year.

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