If someone you care for is going to be discharged from hospital soon, it is normal to feel a wide range of emotions. You could feel excitement that they are coming home or unease about how you will manage without the hospital’s support.
It may also feel a bit overwhelming. Maybe this is the first time you are taking on caring responsibilities for them. Or perhaps your caring role may be about to change if they have different needs after their stay.
It can also feel quite confusing trying to understand exactly what will happen throughout the discharge process and what you, as a carer, can do to help.
Below is some further information and advice to help you navigate this transition successfully.
What will happen when the person I care for is discharged from hospital?
The discharge process will look slightly different for everyone, as each hospital has its own discharge policy. Ask the hospital for a copy of theirs if you would like to know exactly what will happen.
These policies are all based on the same government guidance, however, there will be many similarities.
This is the name of the process used by the hospital to decide whether the person being discharged requires more care when they leave hospital. It is conducted once a patient is assessed as being medically fit for discharge.
This process should involve the input of the person being discharged as much as possible. Also, as their carer you should be informed throughout and have the chance to contribute too.
There are two possible outcomes to a hospital discharge assessment: minimal discharge and complex discharge.
Minimal discharge is when the discharge assessment suggests that either no care or little care will be required.
Complex discharge is where more specialist care will be needed. If it is decided that a complex discharge is necessary, the hospital will create a support plan.
This is a document detailing the health and social care needs the patient will have after leaving hospital.
It should include information about the treatment and wider support that the person you care for will receive, as well as information about who is responsible for providing this support, when and how often it will be provided and how it will be monitored and reviewed.
It should also contain the details of a named person who is coordinating the care, as well as contact details of who to get in touch with for both day-to-day enquiries and in an emergency.
The support plan should also make clear any charges to be paid for this care, where this is applicable.
If this will be the first time you take on caring responsibilities, there should also be a separate carer’s assessment carried out. This will be conducted not by the hospital, but by the local authority. It considers whether you, as a carer, will need additional support once the person you care for has been discharged.
It should happen either while the person you care for is still in hospital or soon after they have come home.
If it is decided that you do need further support, the local authority may then also conduct a financial assessment to see whether you will need to contribute anything towards the cost of this support. If the support is provided directly to the person you will be caring for, however, then you as their carer will not be charged for this.
For further information, take a look at our detailed Carer's assessments guide.
What will we be given on the day of discharge?
A written copy of all support plans should be provided to you and the person you care for when they are discharged. If you received a carer’s assessment, then you should also receive a copy of your own support plan. You can request these plans in a different format or language to make the information more accessible.
The hospital should also provide you with a letter for the patient’s GP. This will update their doctor on the treatment they have received, as well as about the ongoing future care required including any medications.
Depending on the patient’s ongoing requirements, you may be provided with a small supply of medication or medical devices (things like wound dressings, syringes or catheters) by the hospital to take home.
If required, the hospital should also provide a sick note or any other information needed for the person you care for's employer or insurance company.
What do I need to do as a carer during the hospital discharge process?
You should take time to consider exactly what role you would like to play in your friend or relative's future care, and how this will affect your own life. It can help to think in advance about how much help you are going to be able to commit to, and whether there are any types of care that you would want support from other people with instead, such as personal care.
Every hospital should make a discharge coordinator available for you to discuss the process with. It is good to speak to the hospital as far in advance as possible about their plans for discharge. They will start making plans for this as soon as the patient is admitted, so it will never be too early. It will help to discuss with them where the person you care for will be discharged to and what level of care you are able to provide yourself, so that this can be factored in.
You will need to arrange a way for the person you care for to be taken home. This could be as simple as arranging a time for yourself or another friend or relative to pick them up. However, sometimes more complicated arrangements are required such as if they need wheelchair-accessible transport. Talk to the hospital staff in advance if you need assistance making transport arrangements and they will be happy to help.
It can help make the transition go smoothly if you are able to prepare everything that the person you care for will need in advance. This could include making sure there are plenty of easy-to-prepare meals in the house, and that all other essentials are easily accessible. If the person you are caring for lives alone, they may find it helpful to have somebody stay with them or visit regularly, at least at first, to help them adjust.
Be sure to let the hospital know the best contact details to use when they send out any further information such as follow-up appointments. This is particularly important if the person you are caring for will not be going home to their normal address.
You will need to either hand in the letter provided by the hospital to the GP’s reception, or put it in the post to the GP’s surgery. It is helpful if this happens as soon as possible after discharge, so that the GP is kept fully informed and is able to quickly issue prescriptions for any further medication that may be required. If you will struggle to be able to give this to the GP yourself, then you can ask the hospital to arrange to have it sent to them directly.
If the person you care for will require medication after leaving hospital, you will likely only be given a small initial starting supply, usually enough to last one week. If further medication is required after this, you will need to order it through their GP’s repeat prescription service. This should be done within a few days of them being discharged. Some GPs require up to 2 days’ notice for repeat prescriptions, and you will want to make sure you have more medication before the hospital supply runs out.
What help and support can I get during the hospital discharge process?
You may feel that the person you care for would benefit from the assistance of an independent advocate during the discharge process. This is somebody who is separate to social services and the NHS whose role is solely to speak up for the patient and to make sure that they are heard. If you think this is something that would be helpful, take a look at our guide 'Getting an independent advocate'.
If you or the person you care for are unhappy about the discharge process, it is best to speak directly to the hospital staff initially. If you do not feel comfortable doing this, or you are still unhappy after trying to resolve the issues with them informally, then you can speak to the hospital’s Patient Advice and Liaison Service (PALS). You could also rate or review the hospital online for other patients to see, or raise a formal complaint using the NHS complaints procedure.
It is normal for carers to feel worried or concerned about having responsibility for medications. It can be daunting being in charge of something so important, especially if there a number of medications for you to coordinate or this is the first time you have had this responsibility. Rest assured that you are not on your own, and that there is a lot of support available to help you feel more at ease.
You can clarify any questions you may have with the hospital directly during the discharge process. They will want to make sure that you fully understand what is required, so will be happy to help. If at a later stage you feel like you would benefit from some further support with understanding any medications, your local pharmacy can provide additional information and reassurance. Just get in touch with them and ask for their New Medicine Service (NMS).
Online Help and Advice
Visit our online support section where we have provided advice and guidance on a range of relevant topics to help you in your caring role.