A plain-English guide for families navigating the NHS discharge process

Receiving a phone call to say your relative is ready to be discharged from hospital can feel like you've been handed a problem with no instructions. You want them home. You want them safe. But you're suddenly expected to know who arranges care, how quickly it all has to happen, and who pays for what — all while you're still adjusting to why they were in hospital in the first place.

This guide explains exactly what the NHS hospital discharge process looks like, what support you're entitled to ask for, and how to find a verified home care provider quickly so your relative can come home with confidence.

What "hospital discharge" actually means

Hospital discharge is the process of a patient leaving hospital and returning either home or to another care setting. In the UK, once a clinician decides a patient is medically fit for discharge, the hospital has a legal obligation under the Health and Care Act 2022 to assess their social care needs and support the transition out of hospital.

"Fit for discharge" does not mean fully recovered. It means the patient no longer requires acute hospital treatment. Many people go home needing significant ongoing support — with personal care, medication management, mobility, or daily tasks they can no longer do independently.

This is the moment home care becomes essential.

Who is responsible for arranging home care after discharge?

This is the question families ask most often — and the answer depends on the patient's circumstances.

If the patient needs care for medical reasons (NHS Continuing Healthcare)

If the patient has a "primary health need" — meaning their main requirement is for health care rather than social care — they may be entitled to NHS Continuing Healthcare (CHC) funding. This means the NHS pays for their care, including home care, in full.

A CHC assessment should be offered before discharge if it appears the patient may qualify. If it isn't offered and you think your relative might qualify, you have the right to ask for one. See Article 3 in this series for a full guide to NHS CHC funding.

If the patient needs care for day-to-day living (local authority)

If the patient's needs are primarily social rather than medical — help with washing, dressing, meals, or getting around at home — the local authority's Adult Social Care team is responsible for assessing and arranging care.

The hospital's discharge coordination team (sometimes called the Integrated Discharge Team or IDT) will ordinarily refer the case to Adult Social Care. A social worker or care coordinator should be in touch.

If the patient is self-funding

If the patient has savings or assets above £23,250 in England (thresholds differ in Wales, Scotland, and Northern Ireland), they will be expected to fund their own care. In this case, the family or patient themselves is responsible for finding and arranging a home care provider — though the hospital discharge team can point you toward local options.

This is where platforms like Care-AI-UK can match you with CQC-registered providers in your area within minutes, without referral fees.

What is a "discharge to assess" arrangement?

You may hear the phrase "discharge to assess" (D2A). This is a NHS England approach that has become standard practice since the pandemic, designed to speed up hospital discharge by arranging temporary care immediately — and then reassessing the patient's long-term needs once they are settled at home.

Under D2A, patients may be discharged with short-term care support funded by the NHS for up to six weeks (sometimes called Reablement or Intermediate Care). After that period, a formal assessment is completed to determine what ongoing support is needed and who will fund it.

If your relative is being discharged under D2A arrangements, it is important to understand that the initial care package may change after the reablement period. Use that time to understand your relative's longer-term needs and explore self-funded or local authority-funded options in parallel.

What to ask the hospital discharge team before your relative leaves

Before your relative is discharged, the hospital is required to:

Complete a discharge needs assessment
Provide a discharge summary to the patient and their GP
Ensure a care plan is in place if ongoing support is needed
Give you and your relative at least 24 hours' notice of the discharge date (the "24-hour discharge notice" introduced in the 2022 guidance)

Before they leave, ask the discharge coordinator or ward nurse:

Has a social care assessment been completed?
Is my relative being considered for NHS Continuing Healthcare or NHS-funded Nursing Care?
What short-term support is being put in place for the first days at home?
Who will be the named point of contact at Adult Social Care?
What equipment is being provided (bed rails, commode, shower chair)?
Has the GP been notified and a follow-up appointment arranged?

Don't be rushed. Discharge teams are under pressure, but your relative has a right to a safe discharge, not just a fast one.

How to find a home care provider quickly after discharge

If your relative is self-funding or you need to find care quickly before the local authority assessment is complete, time matters. Here's a practical sequence:

Step 1: Identify the type of care needed Think about what support is required and when. Personal care (washing, dressing)? Medication prompts? Companionship and meals? Live-in care? The answer affects which providers can help.

Step 2: Search for CQC-registered providers in your relative's area Only search for providers who are registered and inspected by the Care Quality Commission (CQC). CQC registration is a legal requirement for home care providers in England, and ratings (Outstanding, Good, Requires Improvement, Inadequate) are publicly available.

Care-AI-UK lists only CQC-registered providers and uses AI-assisted matching to surface the most appropriate options for your relative's specific needs and location — for free.

Step 3: Check availability Many providers have waiting lists. Contact two or three simultaneously to compare availability and start dates.

Step 4: Ask the right questions Before committing to a provider, ask: What is your CQC rating? Do your carers receive regular supervision? How are care plans updated? What is your process if a carer doesn't arrive? How quickly can care start?

Step 5: Confirm the care plan in writing Once a provider is confirmed, ask for the care plan in writing before care begins. This should specify the schedule, the tasks covered, the names of allocated carers where possible, and the review process.

What if the hospital wants to discharge before you feel ready?

Hospitals are under intense pressure to free up beds, and families sometimes feel rushed into accepting a discharge before appropriate care is in place. You have rights here.

If you don't believe a safe discharge plan is in place, you can:

Ask for a delay and explain your concerns in writing to the ward manager and discharge coordinator
Request a meeting with the social worker assigned to your relative's case
Contact the Patient Advice and Liaison Service (PALS) at the hospital
In England, refer to the NHS Guidance on Hospital Discharge and Community Support (2022) which states discharge must be safe, and not merely fast

The hospital cannot discharge a patient to a location without appropriate care in place if doing so would put the patient at risk.

Checklist: before your relative comes home

Use this checklist to feel confident you've covered the essentials:

Discharge summary received and understood
GP notified with follow-up appointment booked
Home assessed for safety (loose rugs, bathroom grab rails, clear pathways)
Equipment delivered (if prescribed)
Medication prescribed and dispensed
Home care provider confirmed with start date agreed
Emergency contact list updated and visible in the home
Neighbour or family member briefed on first-day support
Social care assessment complete (or requested if outstanding)

Next steps

Finding the right home care provider doesn't have to be stressful. Care-AI-UK matches families with verified, CQC-registered providers in your area — based on your relative's specific needs, your location, and availability. The service is free for families and takes minutes.

Find a verified home care provider near you →

In this series:

What Happens to Home Care When Someone Is Discharged from Hospital?