The short answer
- Going back in is common, and more common with ageIn England in 2024/25, 14.7% of emergency admissions came within 30 days of that person's previous discharge. For people aged 75 and over it was 17.8%.
- The same few reasons come up in every listFalls, urinary infections and chest infections appear in the published reasons after a broken hip, a hip replacement and a stroke alike.
- Medicines change in hospital, and the changes get missedThe discharge letter lists what was started, stopped and altered. Every community pharmacy in England has to offer an NHS service to go through it with you.
- Who to ring depends on what you are seeingSome things need 999 straight away. Others need the GP the same day, 111, or the ward number on the discharge letter. Write all three down before they come home.
Visits from a carer on PrimeCarers cost £18 to £25 an hour with our fee included, typically about £20. Agencies charge £28 to £35 an hour for the same visit. This page describes discharge in England.
Why people go back in
How often people go back in, and what they go back in with
These figures are not usually part of the conversation on the ward, so they are worth seeing once. NHS England Digital counts how many emergency admissions come within 30 days of that person's previous discharge, and publishes a breakdown of what people were readmitted with.
In 2024/25, 14.7% of emergency admissions to hospital in England came within 30 days of that person's last discharge. Among people aged 75 and over it was 17.8%, or 286,503 admissions in the year. That is not a measure of care going wrong. People who have just been in hospital are the people most likely to need it again.
NHS England Digital also publishes the recorded reasons for three groups of patients. The six commonest named reasons in each are below.
After a broken hip
12.9% came back within 30 days
Discharged after a fractured neck of femur, an emergency admission and usually an older person.
- A tendency to fall5.4%
385 readmissions
- A urinary tract infection4.2%
300 readmissions
- Another fracture of the neck of the femur4.2%
299 readmissions
- Lobar pneumonia4.2%
297 readmissions
- Pain in a joint3.7%
265 readmissions
- Pneumonia, type not specified3%
215 readmissions
7,148 of 55,596 came back as an emergency within 30 days.
After a first hip replacement
4.9% came back within 30 days
Discharged after primary hip replacement surgery, mostly planned and mostly a fitter person.
- Other specified soft tissue disorders10.9%
459 readmissions
- A mechanical problem with the new joint6.5%
273 readmissions
- Pain in a joint4.4%
184 readmissions
- Pain in a limb3.9%
165 readmissions
- Infection around the new joint3.3%
140 readmissions
- Bleeding or a haematoma after the operation3%
125 readmissions
4,199 of 85,055 came back as an emergency within 30 days.
After a stroke
11.8% came back within 30 days
Discharged after a stroke, where some of what brings people back is the illness itself.
- Another stroke, cause not specified6.5%
536 readmissions
- Another stroke, type not specified5.4%
445 readmissions
- A tendency to fall2.7%
220 readmissions
- A urinary tract infection2.3%
192 readmissions
- Pneumonia caused by food or vomit going into the lungs2.3%
187 readmissions
- Lobar pneumonia2%
162 readmissions
8,251 of 69,813 came back as an emergency within 30 days.
NHS England Digital, Reason for Emergency Readmission (I02043), discharges in England in 2024/25. Each percentage is that reason's share of the emergency readmissions in its group. Lists are the six most common named reasons, so they do not add up to the whole; a residual code for unknown and unspecified causes is left out.
Some of what sends people back cannot be prevented at home. A second stroke is the largest entry in the stroke list, and a mechanical problem with a new joint is near the top of the hip replacement list. Those belong to the illness or the operation.
The rest of each list is different. A tendency to fall is the commonest named reason after a broken hip. Urinary tract infections appear in all three lists, and so does pneumonia. Falls, infections, poor fluids and medication problems are the part of the picture daily life at home reaches, and they are what the rest of this page is about. The hospital discharge and post-operative care pillar covers the weeks either side. If your relative is home after a hip operation, recovery at home after a hip replacement goes through those weeks, and hospital discharge explained covers the pathways and who pays for the first six weeks.
The first days home
The first days home, and what needs to be in place for them
The days straight after a discharge have the least support around them. The ward has stopped, community services may not have started, and the person is weaker than when they went in. Working through this before the discharge date is worth more than anything done afterwards.
- Before discharge
Ask for the discharge summary and the phone numbers
NICE says the discharge summary should reach the GP within 24 hours and that a copy is given to the person on the day they leave. Ask for that copy, and for a number to ring about medicine or equipment problems in the first 24 hours.
- Before discharge
Check the equipment is there, not ordered
NICE says essential specialist equipment should be in place at the point of discharge. A raised toilet seat or a frame that has been ordered but not delivered is the difference between a safe first night and a fall in the dark.
- Day 1
Somebody with them for the first night
Pain relief given on the ward at six in the evening runs out in the small hours, in an unfamiliar half-light. This can be a family member on the sofa or a sleeping night from a carer, which starts at £130 on PrimeCarers.
- Days 1 to 3
Fluids, food and the walk to the toilet
Three things in the readmission lists start here: dehydration, a urinary infection and a fall on the way to the bathroom. A jug within reach, small meals, and a clear route to the toilet with a light on cover most of it.
- Days 1 to 3
A call or a visit from the GP or a community nurse
NICE says a GP or community-based nurse should phone or visit people at risk of readmission 24 to 72 hours after their discharge. If nothing has come by day three, ring the surgery, say your relative has just been discharged and ask for it.
- Weeks 1 to 6
The follow-up dates, and the date the free support ends
Put the follow-up appointment, the stitch or clip removal and any therapy dates on one calendar. Where a council provides reablement or intermediate care it cannot charge for the first six weeks, and the assessment of what comes next does not always land before that date.
NICE also says people at risk of readmission should be referred to community health and social care practitioners before they leave, and that those practitioners should keep in contact afterwards. If nobody has been named to you, ask the ward who is coordinating the discharge, and ask for that name and number in writing. What to arrange before discharge day is the fuller list for the days beforehand, and reablement after a hospital stay explains what the short-term support does and does not cover.
The medicines
Getting the medication right, which is where a lot of it goes wrong
A hospital stay usually changes somebody's tablets. Something is started, something is stopped, a dose goes up, and a painkiller is added that was never there before. The person comes home with a bag of boxes, and nobody has set the old list and the new one side by side.
- 1
Read the medication section of the discharge letter
Day of dischargeIt lists what was started, stopped and changed, and it is the document the GP works from. Photograph it, and show it to any carer who is visiting. - 2
Take the old boxes out of the cupboard
Day 1A tablet stopped in hospital can still be sitting in the kitchen in its old packet, and it is easy to carry on taking it from habit. Put anything no longer prescribed in a bag for the pharmacy. - 3
Use the NHS Discharge Medicines Service
First weekHospitals refer patients to their nominated community pharmacy with the changes made in hospital, and the pharmacy compares what has come home with what the person was taking before. NHS England describes it as an essential service all community pharmacy contractors must provide. If no referral was made, ask anyway. - 4
Write one sheet and keep it by the tablets
First weekThe tablet, the dose, the time and what it is for. Pain relief timings matter as much as the rest, because pain left to build stops somebody moving and eating. Ask about a blister pack if the list is long; they take time to set up. - 5
Ask the GP for a review if something feels off
Weeks 1 to 6New confusion, drowsiness, dizziness on standing or constipation that will not shift can follow a medication change, and the NHS lists some prescription medicines among the causes of sudden confusion. Ring rather than wait for the follow-up.
If somebody is prompting or giving the tablets rather than the person managing alone, agree who does what and write it down. Can carers give medication? sets out what a carer can and cannot do with medicines, and the care plan guide covers how to record it so everybody visiting works from the same page.
What to watch for
What to watch for in the first weeks, and who to ring
Most of this is ordinary observation rather than nursing, which is why somebody in the house every day matters. Not everything here is a 999 call, and knowing which is which stops a family waiting too long, or spending a night in the emergency department.
| What it can be | Who to ring, and when | |
|---|---|---|
| Sudden confusion, or somebody not making sense | The NHS names infection as a cause of sudden confusion, and says urinary tract infections are a common cause in older people and people with dementia. Some prescription medicines can do it too. | The NHS says to go to A&E or call 999 if someone suddenly becomes confused. |
| A very high or low temperature, shivering, difficulty breathing, or skin, lips or tongue that look blue, pale, grey or blotchy | These are among the sepsis symptoms the NHS lists for adults, with slurred speech and passing very little urine. | Call 999 or go to A&E. The NHS says not to drive yourself there. |
| Throbbing pain or swelling in one leg, or skin on the calf or thigh that looks red, blue or darker | The NHS lists these as symptoms of a deep vein thrombosis, and names recent surgery and being confined to bed for three days or more among the risks. | Contact 111. Call 999 or go to A&E if there is chest pain or breathlessness too. |
| A wound that is redder, hotter or more painful than it was, or leaking green or yellow fluid | NHS trusts describe those signs, with feeling unwell or feverish, as a wound infection to act on. Some redness and swelling after an operation is expected. | The GP in surgery hours, 111 outside them, or the ward number on the letter. |
| Cloudy or strong-smelling urine, pain passing it, or new incontinence | The NHS lists these among urinary tract infection symptoms, and says that in frail older people the sign can instead be agitation, confusion or wetting themselves more than usual. | The NHS says to ask for an urgent GP appointment or help from 111 if the person is 65 or over. |
| A fall, or a near miss getting out of bed or to the toilet | A tendency to fall is the commonest named reason people come back in after a broken hip, and it appears in the stroke list too. | 999 for a head injury, a suspected broken bone, or anyone you cannot get up safely. Otherwise the GP, and ask about a falls assessment. |
Sudden confusion, or somebody not making sense
- What it can be
- The NHS names infection as a cause of sudden confusion, and says urinary tract infections are a common cause in older people and people with dementia. Some prescription medicines can do it too.
- Who to ring, and when
- The NHS says to go to A&E or call 999 if someone suddenly becomes confused.
A very high or low temperature, shivering, difficulty breathing, or skin, lips or tongue that look blue, pale, grey or blotchy
- What it can be
- These are among the sepsis symptoms the NHS lists for adults, with slurred speech and passing very little urine.
- Who to ring, and when
- Call 999 or go to A&E. The NHS says not to drive yourself there.
Throbbing pain or swelling in one leg, or skin on the calf or thigh that looks red, blue or darker
- What it can be
- The NHS lists these as symptoms of a deep vein thrombosis, and names recent surgery and being confined to bed for three days or more among the risks.
- Who to ring, and when
- Contact 111. Call 999 or go to A&E if there is chest pain or breathlessness too.
A wound that is redder, hotter or more painful than it was, or leaking green or yellow fluid
- What it can be
- NHS trusts describe those signs, with feeling unwell or feverish, as a wound infection to act on. Some redness and swelling after an operation is expected.
- Who to ring, and when
- The GP in surgery hours, 111 outside them, or the ward number on the letter.
Cloudy or strong-smelling urine, pain passing it, or new incontinence
- What it can be
- The NHS lists these among urinary tract infection symptoms, and says that in frail older people the sign can instead be agitation, confusion or wetting themselves more than usual.
- Who to ring, and when
- The NHS says to ask for an urgent GP appointment or help from 111 if the person is 65 or over.
A fall, or a near miss getting out of bed or to the toilet
- What it can be
- A tendency to fall is the commonest named reason people come back in after a broken hip, and it appears in the stroke list too.
- Who to ring, and when
- 999 for a head injury, a suspected broken bone, or anyone you cannot get up safely. Otherwise the GP, and ask about a falls assessment.
Symptom lists are from nhs.uk pages on sepsis, deep vein thrombosis, sudden confusion and urinary tract infections, and from NHS trust wound care guidance. This is a care page, not a medical one, so when in doubt, ring rather than look it up.
A carer visiting daily is often the one who spots these first, because they see somebody at the same time each day and notice a change over a week. How to deal with elderly falls covers what to do at the time, and mobility and falls care covers reducing the risk. On the other two that show up in the figures, what happens when the elderly do not eat enough and how serious dehydration is in older people explain why they matter this much after a hospital stay.
What help at home covers
What a carer at home covers in these weeks, and what it costs
Short-term NHS and council support is built around getting somebody back to doing things for themselves, and it is usually a daytime service that tapers. A carer arranged privately fills the hours it leaves, rather than replacing it.
Medication prompts at the right times
Meals, and fluids somebody keeps an eye on
The physiotherapy sheet, done with them
The nights, if the nights are the worry
Carers on PrimeCarers charge £18 to £25 an hour with our fee included, typically about £20, against £28 to £35 an hour through an agency. Hourly care after a hospital stay sets a short private package next to reablement, short-term night care after a hospital discharge covers the nights, and funding care after a hospital stay covers help with paying once the free period ends.
PrimeCarers introduces carers and families to each other. We do not provide or manage care, and carers are self-employed, so the visits, the hours and the rate are agreed between you and the carer. Every carer on the platform has had an identity check, a right to work check and an enhanced DBS check on the Update Service, and has been interviewed online before their profile appears. Their insurance covers them while they work, separately from those checks. References sit on a carer's profile, and skills, training and experience of this kind of recovery are worth asking about when you speak to them. You can search for carers near your relative's home and compare their rates, reviews and availability while the discharge is still being planned, and our pricing explains how the rate and our fee work.
Discharge dates move, so tell a carer as soon as yours does. The contract between a client and a carer says a visit cancelled by the client is payable in full, with unplanned hospitalisation, illness, or another reason agreed with the carer as the exceptions, and a readmission is the first of those. Notice on hourly care is 48 hours, and PrimeCarers charges nothing itself to cancel.
Questions
Questions families ask about going back into hospital
In England in 2024/25, 14.7% of emergency admissions to hospital came within 30 days of that person's previous discharge, according to NHS England Digital's emergency readmissions indicator. For people aged 75 and over it was 17.8%, which was 286,503 admissions over the year.
NHS England Digital publishes the recorded reasons for three groups. After a broken hip they are led by a tendency to fall, a urinary tract infection, another fractured neck of femur and pneumonia. After a first hip replacement, by soft tissue problems, a mechanical problem with the new joint and joint pain. After a stroke, by another stroke.
Work on the things in those lists that daily life reaches. Get the medication changes onto one sheet and checked by a pharmacy. Keep fluids going and meals small and frequent. Clear the route to the toilet and keep a light on at night. Get somebody moving a little every day. None of that is nursing, and a family member or a carer can do it.
NICE guidance on the transition between hospital and community settings says a GP or community-based nurse should phone or visit people at risk of readmission 24 to 72 hours after discharge. If nothing has come by the third day, ring the surgery, say your relative has just been discharged and ask for it.
It depends what you are seeing. Call 999 or go to A&E for sudden confusion, for the sepsis symptoms the NHS lists such as difficulty breathing or skin that looks blue, pale, grey or blotchy, or after a fall with a head injury. Ring 111 for a suspected blood clot in a leg. Ring the GP the same day for a wound that looks infected, or for urinary symptoms in anyone aged 65 or over.
Speak to the carer as soon as you know. The contract between a client and a carer says a visit cancelled by the client is payable in full, with unplanned hospitalisation, illness, or another reason agreed with the carer as the exceptions, and a readmission is the first of those. Notice on hourly care is 48 hours. PrimeCarers charges nothing itself to cancel and does not set the terms between you and the carer.