The short answer
- A discharge lounge is a waiting area for people ready to leavePeople who no longer need a ward bed wait there for their medicines, their paperwork or their lift home, which is why the wait can run on into the evening.
- Ask six questions before you agree to tonightAsk who will be there, whether the medicines are ready and how they are getting home. Then ask whether the letter is written, whether they can get into the house, and who to ring tonight.
- The hospital does not have to keep them, but it has to discharge them safelyThe national guidance says nobody should be discharged until it is safe to do so. It also says people have no right to stay in a bed they no longer need.
- The first night and the first morning can be covered at short noticeA sleeping night from a carer on PrimeCarers starts at £130, and morning visits cost £18 to £25 an hour with our fee included.
Agencies charge £28 to £35 an hour for a similar visit. This page describes discharge from hospital in England.
The discharge lounge
What a discharge lounge is, and why people can wait there for hours
Where a hospital has one, the discharge lounge is a room where patients who are ready to go home wait for the last few things to be done. If your relative has been moved there, it means the decision that they can leave has been made. It does not mean they are about to walk out of the door.
Moving somebody off the ward frees the bed for the next patient who needs it. The lounge is staffed by nurses and healthcare assistants, and there are chairs, sometimes beds, drinks and something to eat. University College London Hospitals says it asks patients to wait in its lounge if they cannot go straight home, and that they wait there to be collected and for their take-home medicines. Opening hours vary a great deal. UCLH's main lounge closes at eight on weekday evenings, while Kettering General Hospital runs its lounge 24 hours a day.
Each step below has to be finished before your relative can leave, and each one depends on a different team. That is why the wait is hard to predict, and why a discharge agreed at the morning ward round can still be going on after dark.
- Ward round
A doctor decides a hospital bed is no longer needed
The discharge team takes over from here. What this decision does and does not mean is covered in hospital discharge explained.
- Next
The medicines to take home are written up and made up
A prescription is written on the ward and the hospital pharmacy dispenses it. UCLH tells patients to expect an average wait of about an hour for their medicines, and Kettering says up to two hours from when they are ordered.
- Next
The discharge letter is written
This is the summary for the GP, with the medicine changes on it. NICE says a copy should be given to the person on the day they leave.
- Moved
Your relative waits in the lounge
Kettering says staff tell a relative or friend when a patient has been moved there, and that the family can come once everything needed for the discharge is ready.
- Transport
The lift home arrives
If you are collecting, this is in your hands. Hospital transport is booked only for people who meet the NHS criteria, and Kettering says there is a four-hour window from when a patient is ready to when they are collected.
- Home
They arrive home, sometimes late in the evening
From here the evening is the family's to plan: who is in the house, something to eat and drink, and when the next tablets are due.
Knowing where the delay is tells you what to ask. If it is the pharmacy, ask how long they expect to be. If it is transport, ask whether you could collect instead. The one delay a family can often remove is the lift home, and the national guidance prefers it. The Department of Health and Social Care's discharge guidance says transport home should come from family or carers, the voluntary sector or a taxi where possible, with NHS patient transport as a last resort. If your relative has had sedation or an anaesthetic, whether a taxi home is allowed after sedation explains why most units say no.
The phone call
Six questions to ask before you agree to a discharge tonight
A nurse ringing at the end of a shift is often trying to confirm a plan quickly, and it is easy to say yes before you have thought about it. These six questions take a few minutes. They tell you whether tonight will work, and if it will not, they tell the ward exactly what is missing.
Ask the ward
Why it matters tonight
If the answer is yes
If the answer is no
Question 1
Will anybody be at home with them tonight?
Why it matters tonight
The national guidance says any unpaid carer should be asked whether they are willing and able to give care after a discharge. The ward may be assuming that you will be there.
If the answer is yes
Tell the ward who it will be and what time they can be at the house, so the journey home is timed to meet them.
If the answer is no
Say so in plain words. It is information the ward needs in order to plan, and it is not a complaint. Ask whether the discharge could happen in the morning instead.
Question 2
Have the medicines been made up, and will they come home with them?
Why it matters tonight
Medicines to take home are written up on the ward and made up by the hospital pharmacy, and the wait for them is one of the reasons people sit in a discharge lounge. NHS guidance says the supply is usually enough for seven days.
If the answer is yes
Ask what is new, what has stopped, and whether anything is due tonight before bed.
If the answer is no
Ask how long the pharmacy expects to be, and whether your relative will leave with the tablets in their bag. A dose due at bedtime should not depend on a chemist that has already closed.
Question 3
How are they getting home, and at what time?
Why it matters tonight
NHS England says most people should travel home with family or friends, by taxi or by public transport. Hospital transport is kept for people with a medical need for it, and one hospital tells patients it can come up to four hours after they are ready.
If the answer is yes
Ask for the time window rather than a single time, and make sure somebody can let them in at the other end.
If the answer is no
If you are collecting, agree a time with the ward or the lounge before you set off. If nobody can collect, ask what the hospital proposes instead.
Question 4
Has the discharge letter been written?
Why it matters tonight
NICE says the discharge summary should reach the GP within 24 hours and that a copy should be given to the person on the day they leave. It says what was done and what changed with the medicines.
If the answer is yes
Ask for the copy to travel home with them, and photograph it once it arrives.
If the answer is no
Ask when it will be ready. A copy in hand matters more after an evening discharge, because the GP surgery will not open until the morning.
Question 5
Can they get into the house, and is it warm?
Why it matters tonight
NHS guidance lists knowing where the house keys are among the things staff should check before somebody goes home. NICE says people vulnerable to a cold home should have a discharge plan that includes making sure their home is warm enough.
If the answer is yes
If somebody can go ahead, put the heating on, the bed ready and something simple to eat and drink in the kitchen.
If the answer is no
Ask the ward to check the property bag for keys before transport is booked. If nobody can get into the house tonight, tell the ward straight away, because the plan cannot go ahead as it stands.
Question 6
Who do we ring tonight if something goes wrong?
Why it matters tonight
NICE says the discharge coordinator should consider giving people with complex needs a contact for medicine and equipment problems in the first 24 hours. The national guidance says the discharge information should explain how to raise concerns.
If the answer is yes
Write the number on the discharge letter and on a note by the phone.
If the answer is no
Ask for the ward’s direct number. Outside surgery hours NHS 111 gives urgent advice, and 999 is for an emergency.
Drawn from the Department of Health and Social Care's hospital discharge guidance, NICE guideline NG27, NHS guidance on leaving hospital and NHS England's patient transport criteria. Each hospital also has its own discharge policy, and the ward manager or PALS can give you a copy.
You do not need to be confrontational to ask any of this. The questions are the same ones the hospital's own checklist covers, and asking them helps the ward as well as you. The NHS page on planning to leave hospital says staff should make sure that somebody is taking you home, that you know where your house keys are, that you have any medicine or equipment you need, and that unpaid carers know you are coming home.
If you were given a few days' warning, what to arrange before discharge day goes through the equipment, the keys, the food and the first night in more detail. This page is for when there is no time left for that. Leaving hospital: what to arrange is the fuller list to work through on the ward.
Late and night discharges
What the guidance says about discharging somebody late in the day
There is no national rule saying a hospital in England cannot discharge somebody after a certain hour. What the national guidance and NICE do set out are the conditions a discharge has to meet, whatever the time on the clock.
| What it says | What it means for tonight | |
|---|---|---|
| DHSC guidance: a safe discharge | No person should be discharged until it is safe to do so, including making sure unpaid carers have been asked whether they are willing and able to provide care. | A discharge that relies on you being there is not ready until somebody has asked you. You can say you cannot be there tonight. |
| DHSC guidance: staying in hospital | People do not have the right to remain in a hospital bed if they no longer need care in that setting. | The question is how they get home safely and when, rather than whether they go. |
| NICE guideline NG27, 1.5.12 | Pressure to make beds available should not result in unplanned and uncoordinated hospital discharges. | A discharge put together in a hurry at the end of the day, with nothing arranged, is the kind of discharge NICE warns against. |
| NICE guideline NG27, 1.5.10 | Ensure continuity of care for people leaving hospital, particularly older people who may be confused or who have dementia. | If your relative becomes confused in the evening, say so. A move at night into a dark house is harder for them than for most. |
| NHS: being discharged from hospital | Each hospital has its own discharge policy, and you should be able to get a copy from the ward manager or PALS. | Ask whether the hospital's policy says anything about discharges late in the evening or at night. |
DHSC guidance: a safe discharge
- What it says
- No person should be discharged until it is safe to do so, including making sure unpaid carers have been asked whether they are willing and able to provide care.
- What it means for tonight
- A discharge that relies on you being there is not ready until somebody has asked you. You can say you cannot be there tonight.
DHSC guidance: staying in hospital
- What it says
- People do not have the right to remain in a hospital bed if they no longer need care in that setting.
- What it means for tonight
- The question is how they get home safely and when, rather than whether they go.
NICE guideline NG27, 1.5.12
- What it says
- Pressure to make beds available should not result in unplanned and uncoordinated hospital discharges.
- What it means for tonight
- A discharge put together in a hurry at the end of the day, with nothing arranged, is the kind of discharge NICE warns against.
NICE guideline NG27, 1.5.10
- What it says
- Ensure continuity of care for people leaving hospital, particularly older people who may be confused or who have dementia.
- What it means for tonight
- If your relative becomes confused in the evening, say so. A move at night into a dark house is harder for them than for most.
NHS: being discharged from hospital
- What it says
- Each hospital has its own discharge policy, and you should be able to get a copy from the ward manager or PALS.
- What it means for tonight
- Ask whether the hospital's policy says anything about discharges late in the evening or at night.
Sources: the Department of Health and Social Care's hospital discharge and community support guidance (last updated January 2024), NICE guideline NG27 on transition between inpatient hospital settings and community or care home settings, and the nhs.uk page on being discharged from hospital.
A late discharge is not wrong in itself. Some people would rather sleep in their own bed than spend another night on a ward, and for somebody fit, with a partner at home and a lift waiting, nine at night may suit everybody. What matters is whether the things in the call sheet above are in place, and NICE's guideline on moving between hospital and home is written around that kind of planning rather than around the time of day. The same discharge can be fine for one person and unsafe for another.
The concern is sharper for somebody who is frail, lives alone or becomes confused. In 2016 the Parliamentary and Health Service Ombudsman published a report on complaints it had investigated about unsafe discharges. Two of the four problems it set out were relatives and carers not being told that somebody had been discharged, and patients being sent home with no care plan in place. If your relative has dementia, hospital stays with dementia covers what to tell the ward, and it is worth repeating it on the phone tonight.
If the words the ward uses are new to you, hospital discharge explained covers what medically fit for discharge means, the four discharge pathways and who pays for the first six weeks.
Raising a concern
Raising a concern, and what a family can and cannot refuse
If the answers to the questions leave a gap, you are entitled to say so, and the right person to say it to is on the ward tonight. It helps to be clear about what raising a concern can change, and what it cannot.
What you can reasonably ask for
- To say that you are not able to be at the house tonight, and to have that taken into account
- To ask whether the discharge could happen tomorrow morning instead, and why it has to be tonight if the answer is no
- To speak to the nurse in charge or the ward manager, rather than to whoever answered the phone
- To ask for the medicines, the letter and a number to ring before they leave
- To see the hospital's own discharge policy
What a family cannot insist on
- That the hospital keeps somebody in a bed once they no longer need hospital care
- That they stay in until a particular care home, carer or package you would prefer is available
- That saying you cannot collect them will keep them on the ward, since the hospital can arrange other transport
Start with the nurse in charge of the ward that evening, or the ward manager if they are there, and describe the gap in concrete terms. "She lives alone, she has been confused in the evenings and nobody can reach the house until tomorrow" is far easier to act on than "we are not happy". Ask what they propose. A nurse who hears the specific problem has something to work with.
If that does not settle it, every hospital has a Patient Advice and Liaison Service, known as PALS, which gives confidential advice and can take up a problem with the ward. The NHS has a PALS finder. Check the PALS opening hours on the hospital's website, because a concern tonight is best raised with the ward first. After that comes the hospital's complaints process, and then the Parliamentary and Health Service Ombudsman. Age UK's factsheet on hospital discharge sets out the same route and explains the free NHS complaints advocacy service.
Cover at short notice
Putting cover in place for tonight and tomorrow morning
Sometimes the discharge goes ahead tonight and the gap is yours to fill. The two points that matter most are the first night and the first morning, when the washing, the dressing, breakfast and the first tablets all fall due at once.
| What it covers | When it suits | What it costs | |
|---|---|---|---|
| A family member stays over | Somebody in the house to help them to the toilet, fetch the tablets and ring for help | Tonight, if somebody can get there | No fee, though somebody gives up the time |
| A sleeping night from a carer | A carer who sleeps in the house and gets up if needed, and sees them into the morning | The first night or two, when help may be needed once or twice | From £130 a night on PrimeCarers |
| A waking night from a carer | A carer who stays awake all night | Pain that has not settled, or confusion at night | From £150 a night on PrimeCarers |
| A morning visit from a carer | Getting up, washing, dressing, breakfast and the morning tablets | Tomorrow morning, and for as many mornings as needed | £18 to £25 an hour on PrimeCarers |
A family member stays over
- What it covers
- Somebody in the house to help them to the toilet, fetch the tablets and ring for help
- When it suits
- Tonight, if somebody can get there
- What it costs
- No fee, though somebody gives up the time
A sleeping night from a carer
- What it covers
- A carer who sleeps in the house and gets up if needed, and sees them into the morning
- When it suits
- The first night or two, when help may be needed once or twice
- What it costs
- From £130 a night on PrimeCarers
A waking night from a carer
- What it covers
- A carer who stays awake all night
- When it suits
- Pain that has not settled, or confusion at night
- What it costs
- From £150 a night on PrimeCarers
A morning visit from a carer
- What it covers
- Getting up, washing, dressing, breakfast and the morning tablets
- When it suits
- Tomorrow morning, and for as many mornings as needed
- What it costs
- £18 to £25 an hour on PrimeCarers
All PrimeCarers figures include our fee, and carers set their own rates. Agencies charge £28 to £35 an hour for a visit. A carer is not a nurse, so anything clinical stays with the ward number, the GP or NHS 111.
If you are reading this in the evening, you can search for carers near your relative's home now, look at their profiles, rates, reviews and availability, and message the ones who could come tomorrow morning. You speak to the carer and agree the time and the rate with them directly. The emergency care page also has an urgent request form, where you tell us what has happened and we start ringing carers near your relative. Asking is free, and a one-off £40 fee is charged only if you go ahead with a carer found that way. Searching yourself costs nothing.
PrimeCarers introduces families and carers to each other. We do not provide or manage care, and carers are self-employed. 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 training and experience after a hospital stay are worth asking about when you speak to them. Our pricing explains how the rate and our fee work.
For the night itself, short-term night care after a hospital discharge explains what a carer does overnight, and waking night or sleeping night helps you choose between the two. For the days after, hourly care after a hospital stay sets visits alongside reablement. If the discharge has been put off until tomorrow and nothing is arranged yet, discharge is tomorrow and there is no care in place covers the council and NHS help to ask for alongside it. Avoiding readmission covers what to watch for in the first weeks at home.
Discharges that are planned for the evening do sometimes get put back to the next day. If you have booked a carer and that happens, tell them as soon as you know. The contract between a client and a carer says a visit cancelled by the client is payable in full, except for unplanned hospitalisation, illness, or another reason agreed with the carer. Notice to end hourly care is 48 hours. PrimeCarers charges nothing itself to cancel and does not set the terms between you and the carer.
Questions
Questions families ask about late discharges
It is a waiting area for patients who have been told they can go home and no longer need a ward bed. They wait there, looked after by nurses and healthcare assistants, for their take-home medicines, their discharge letter or their transport. Moving them there frees the ward bed for somebody else. Opening hours vary between hospitals, and some lounges run through the night.
There is no national rule in England that sets a time after which a hospital cannot discharge somebody. The national guidance says nobody should be discharged until it is safe to do so, and NICE says the pressure to free beds should not lead to unplanned and uncoordinated discharges. Each hospital has its own discharge policy, and you can ask the ward manager or PALS for a copy.
You can say that you are not able to be there, and the guidance says unpaid carers should be asked whether they are willing and able to provide care before somebody is discharged. What a family cannot do is make the hospital keep somebody in a bed they no longer need. Explain what is missing, ask whether the discharge can happen in the morning, and speak to the nurse in charge if the plan still does not work.
Start with the nurse in charge or the ward manager, at the time if you can. If that does not resolve it, contact the hospital's Patient Advice and Liaison Service (PALS). After that comes the hospital's formal complaints process, and then the Parliamentary and Health Service Ombudsman. A free NHS complaints advocacy service can help you through it, and your council can tell you who provides it locally.
It can be. NICE asks hospitals to ensure continuity of care when people leave, particularly older people who may be confused or who have dementia. An evening journey into a dark, cold house, with no familiar person there, is harder for somebody with dementia. Tell the ward about it on the phone, and say who will be with her when she arrives. Hospital stays with dementia covers what else to tell them.
You can search for carers near your relative's home tonight and message the ones who show availability. Visits cost £18 to £25 an hour on PrimeCarers with our fee included, and a sleeping night starts at £130. You agree the visit and the rate with the carer directly. If the discharge is then put back, tell the carer straight away.