Discharge planning

Planning your return home, leaving hospital, your 'discharge'!

Once you have stepped down to the ward you will continue to be set goals for your recovery that will be supported by the ward team. The ward team consist of the following key members:

• Doctors including your consultant leading your care
• Ward nurses with a nurse in charge on each shift and matron overseeing nursing care on that ward
• Physiotherapy
• Occupational therapy
• Dietitian
• Pharmacist
• Social worker

The ward is sometimes the first part of the recovery journey where your thoughts start to become clearer. You recognise where you are, what day of the week it is, the time of day and remember conversations with family and the doctors and nurses more clearly.

Eventually, most patients reach the point where they are keen to leave the hospital and go home, but the ward team will need to plan this with you to ensure it is possible, both safely and with the correct support where required. The term 'discharge' is unfortunately often used to describe when you are ready to leave the hospital.

The ward team may need to ask you many questions to plan your return home or discharge from hospital, such as:

• is your home a house or flat, which floor if a flat, is there a lift (that works)?
• how many stairs you have to climb to get into the house and upstairs to the bedroom?
• what are the bathroom and kitchen facilities?
• whether you have relatives or friends who will be able to support you during your recovery?
• will any help or support, which you currently receive from social services or community health professionals, such as district nurses be required to start visiting you again?

The ward team will arrange any/all community services referrals for you e.g. community physiotherapy, occupational therapy or speech and language therapy.

The aim is to make sure all the services you need are in place before you leave hospital:

• community services e.g. district nurses, community physiotherapy
• any all follow-up appointments with specialists at the hospital
• post-ICU recovery clinic follow-up appointment
• requests for you GP to complete e.g. repeat blood investigations
• All patients will be seen by the pharmacist to talk through your medications.

Valuables

Ward staff will return your valuables to you before you leave the hospital or they may request that you collect them from the cashier’s office. If any valuable items are missing or lost then contact the Patient Advice and Liaison service (PALS). https://www.guysandstthomas.nhs.uk/contact-us/your-feedback/contact-pals

A paper copy of your discharge summary will be given to you if you are going home from Guy’s and St Thomas, but otherwise your local hospital will complete this paperwork. The notes detailing you stay in ICU will be sent with you to the local ICU for their records.

A statement of fitness to work “Fit note” also known as “Sick note”

If you need a certificate to claim sickness benefit from your employer then you will need to ask for a “fit note” or “sick note” these are the informal name for the Statement of Fitness for Work. A doctor will assess you and if he or she decides that your health affects your fitness for work, they can issue a fit note and advise that: you are "not fit for work" or "may be fit for work, taking into account advice written in the fit note"

Transport home

This will need to be planned, but often patient’s will either return home in a car with family/friend or carer. Hospital transport is sometimes required when either you are unable to get help with the journey home or are unable to manage public transport.

If hospital transport is organised for you then arrange for a family/friend or carer to be there when you arrive home. We have heard of some stories where patients have been asked to get from the hospital transport car or ambulance to the front door by themselves. This should not happen, but extra help on arrival home can be very helpful.