What to arrange before discharge day

Some of this is the hospital's job and some of it is yours, and the two get confused in the rush. The ward is responsible for the assessment, the equipment it orders, the medicines to take home and the letter to the GP. You are responsible for the house being ready to walk into. Where you are not sure which of the two something is, ask the discharge co-ordinator and write the answer down with a name. Hospital discharge explained covers the words the ward will use, and the hospital discharge and post-operative care pillar covers the weeks either side.

Where a council arranges it, this equipment is free. Regulation 3 of the Care and Support (Charging and Assessment of Resources) Regulations 2014 says a local authority must not charge for community equipment, meaning aids and minor adaptations, and counts an adaptation as minor where it costs £1,000 or less. The NHS page on household gadgets and equipment says the same in plainer words. To buy something yourself in the meantime, the right equipment to aid the elderly goes through what each item does.

Ask for the delivery date rather than confirmation that an order has gone in. Equipment ordered on a Thursday for a Friday discharge can leave a family lifting somebody into a bed that is too low. Where it cannot arrive in time, say so: a discharge held back a day is better than a fall in week one. If falls were already a worry, reducing the risk of falls at home covers the rest of the house.

Who gets the code is worth deciding deliberately rather than on the morning. Keep the list short, write down who has it, and change it when somebody stops coming. The keys appear on the NHS checklist for planning to leave hospital, its page on personal alarms and key safes sets out the options, and keeping an elderly relative safe at home covers doors and locks.

If a carer is visiting, agree all of this with them before the first visit: where the key safe is, what the code is, and what to do if there is no answer. Carers on PrimeCarers are booked directly with the family, so that is a conversation with the person turning up.

1. 1

   Ask for the changes in writing

   Before the day

   What is new, what has stopped, what the pain relief is and how often it can be taken. The ward pharmacist can explain it properly if you ask early enough.
2. 2

   Collect the medicines to take home

   On the day

   NHS guidance says medicine sent home is usually enough for seven days. Dispensing can hold a discharge up for hours, so ask in the morning whether it has been ordered.
3. 3

   Tell the GP surgery

   Before the supply runs out

   A letter goes to the GP with the medication changes on it, and the surgery has to act on that before a repeat is issued. NHS guidance notes some surgeries need up to two working days, so seven days of tablets is not long.
4. 4

   Ask about the pharmacy referral

   Before the day

   Under the NHS Discharge Medicines Service a hospital can refer a patient to their usual pharmacy, which compares what they came home with against what they took before. Every community pharmacy provides it, so ask whether a referral was made.

Photograph the discharge letter before it goes in a drawer. The GP will want it, and anyone visiting will ask what changed. Where the tablets have become complicated, a pharmacy can supply them in a weekly blister pack, though that takes time to set up and is not suitable for every medicine: who qualifies for a dosette box explains how they are arranged.

A carer can prompt and assist with medication and record what was taken, within their own training and what the care plan says, and what carers can and cannot do with medication sets out where that line sits. A written note of what was taken and when lets a GP answer a question about pain relief quickly.

The heating is part of a discharge plan rather than an afterthought. NICE quality standard QS117 says people who are vulnerable to the health problems associated with a cold home should have a discharge plan that includes making sure their home is warm enough, and gives asking a relative or neighbour to switch the heating on in advance as an example. Where money is the reason it has been off, say so to the discharge team, who can refer on to the services that help.

Appetite can be poor for a week or two afterwards, and eating too little while recovering slows everything else down. What happens when an older person does not eat enough sets out what to watch for. A carer cooking something at teatime and sitting with them while they eat it does more for this than a full freezer.

Two or three nights is often all that is wanted, and a smaller decision than it feels at the ward. Short-term night care after a hospital discharge explains what sleeping and waking nights involve, and hourly care after a hospital stay covers the visits either side of them. Where reablement has been offered, reablement and the free six weeks explains what it covers, and funding care after a hospital stay sets out the help with paying.

PrimeCarers is an introductory service. We introduce carers and families to each other and do not provide or manage care, so the visits, the nights and the rate are agreed between you and the carer. Every carer on PrimeCarers 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 and training are worth asking about. You can search for carers near your relative's home and compare rates, reviews and availability while the discharge is being planned, and our pricing explains how the rate and our fee work.

Discharge dates move, so tell a carer you have booked 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 delay because your relative is still on the ward is the first of those. Either side can end the arrangement on 48 hours' notice for hourly care, and PrimeCarers charges nothing itself to cancel.