Who to send it to
The consultant or nurse in charge of the ward, and the discharge coordinator or care transfer hub named on the discharge paperwork. Send a copy to the hospital's Patient Advice and Liaison Service (PALS) and, if social care is involved, to the hospital social work team. Email is quickest; mark it urgent.
The letter
Replace everything in [square brackets], keep a copy, and note the date you sent it.
Tips
- Act quickly: email the ward and the discharge team as soon as you hear the plan, then phone to check the email has been seen. Ask for the name and direct number of the person coordinating the discharge.
- Keep to facts about risk: falls, night-time needs, how many people are needed to help, equipment, medicines and who will actually be there.
- Patients do not have a right to stay in a hospital bed to wait for a preferred care option, but a suitable short-term alternative should be offered while they wait. Ask what that alternative is.
- Ask which pathway is planned: home with no new care (pathway 0), home with new support (pathway 1), a short stay in a community bed (pathway 2) or a care home (pathway 3). A first permanent care home placement straight from hospital should happen only in exceptional circumstances.
- Anyone who needs formal care after discharge should get a safety and welfare check on the day they go home. Ask who will do it and when.
- If concerns are not dealt with, contact the hospital's Patient Advice and Liaison Service (PALS), and keep a record of every conversation.
The law behind it
Section 74 of the Care Act 2014 (substituted by section 91 of the Health and Care Act 2022, in force since 1 July 2022): where an NHS trust thinks an adult patient is likely to need care and support after discharge, it must, as soon as is feasible after it starts planning the discharge, take appropriate steps to involve the patient and any unpaid carer. The statutory Hospital Discharge and Community Support Guidance (updated January 2024): planning should start on admission; it is good practice to set an estimated discharge date within 48 hours of an emergency admission and share it with the patient, family and unpaid carers; people should be supported to make informed choices; and anyone who needs formal care should have a safety and welfare check on the day of discharge. If the person lacks capacity to decide, decisions must be made in their best interests under section 4 of the Mental Capacity Act 2005. Regulation 21 of the Standing Rules Regulations 2012: NHS Continuing Healthcare must be considered where it appears there may be a need.
Read more in our guide: Leaving hospital: what to expect and how to prepare.
Legal references checked 30 October 2026. General information, not legal advice.