Revised hospital discharge guidance introduces new duties for hospitals

NHS England has updated its hospital discharge and community support guidance to reflect the changes introduced by the Health and Care Act 2022 which came into force on 1 July 2022. It updates the March 2022 version of the guidance.

This guidance sets out how NHS bodies (including commissioning bodies, NHS trusts and NHS foundation trusts) and local authorities can plan and deliver hospital discharge and recovery services from acute and community hospital settings that are affordable within existing budgets available to NHS commissioners and local authorities.

Readers will recall that, from 1 April 2022, the guidance stated that local areas should adopt discharge processes that best meet the needs of the local population. This could include the ‘discharge to assess, home first’ approach. Systems should work together across health and social care to jointly plan, commission, and deliver discharge services that are affordable within existing budgets available to NHS commissioners and local authorities, pooling resources where appropriate.

What’s changing

Section 91 of the Health and Care Act revokes procedural requirements in Schedule 3 to the Care Act 2014 which require local authorities to carry out long-term health and care needs assessments, in relevant circumstances, before a patient is discharged from hospital.

Section 91 also introduces a new duty for NHS trusts and foundation trusts to involve patients and carers (including young carers) in discharge planning.

This applies in situations where an adult patient is likely to need care and support after their hospital discharge, and the trust considers it appropriate to involve them or their carers in planning their hospital discharge. Hospitals will need to take steps to put this in hand as soon as possible after the trust begins making any plans relating to the patient’s discharge.

Under this duty, a carer is defined as an individual who provides or intends to provide care for an adult, otherwise than by virtue of a contract or as voluntary work.

More detail about this new duty will be set out in the next update to this guidance, which is expected in autumn 2022.

As a reminder Appendix 2 sets out the specific responsibilities for hospital discharge for:

• commissioners of health and care;
• local authorities;
• adult social care and care providers; and
• acute health providers.

We'll update you in the autumn with the new version of this guidance.