How you can prepare

You may feel concerned about how you will cope after you are discharged from hospital. Many people worry they will be a burden on their family, but there are many people who can give different kinds of support.

You may need equipment such as hand rails or a stair lift, or help with everyday chores. You may need medical help to change dressings and give injections, or you may need more personal care to be able to wash and dress. Many people may simply need emotional support or someone to talk to.

Your needs will be assessed in detail by a team of professionals including a ward nurse or your keyworker. After your assessment, the healthcare team will make a discharge plan for you. This includes details about the support you will receive at home including where and how often you will receive it, contact details for all health professionals involved and who to contact in emergencies.

Your relatives or carer will also be involved in your needs assessment to ensure they will also receive the support they need. You will only go home when the hospital staff are happy you and your carer will manage.

Preparing to go home


When can I go home?

Everyone will have different support needs when they go home. You should only be discharged from hospital when:

  • your doctors are happy that you are well enough to go home
  • you have been given a written discharge plan of the support that you’ll get
  • the support you need has been looked at and put in place so you can safely manage at home.

The doctors and nurses will tell you when you are likely to be ready to go home. This is known as your expected date of discharge (EDD). This date will be reviewed regularly. You will be told if the date has to change because of your condition or because there is a delay organising the help you need.

Your hospital will have its own discharge policy and arrangements for discharging people. The policy should follow guidelines from the government.

You may go to the home of a relative or friend when you first leave hospital. The information here still applies in this situation.


How is care and support arranged for me?

If you are worried about how you’ll manage at home, tell the nurses or your keyworker as soon as possible. This will help them plan for your discharge. A keyworker is a healthcare professional and they are often a nurse. They are your main contact and source of support during your stay in hospital.

If your stay in hospital has been planned in advance, you should be given information about discharge planning before you are admitted. A clinic appointment (if you have one) before you go into hospital is a good time to discuss any concerns you have about going home again.

Discharge planning can mean that you see lots of different health and social care professionals. It may be difficult to remember who each person is and what they do. If you forget any details, it’s fine to ask for them again.

We also have a table that you could download and use to keep their contact details.

There are no questions that you can’t ask a keyworker. Nothing is too big, too small or too silly – that’s what they are there for.

Michael, Clinical Nurse Specialist


Who arranges your discharge?

Usually a ward nurse or your keyworker will make the plans for you to go home. Ward nurses work as a team, so it may not be the same nurse every day. If needed, the nurse or keyworker will involve other healthcare professionals like physiotherapists or occupational therapists.

Once you get home, you may need ongoing care and support from different organisations and healthcare professionals. If you do, a liaison nurse, nurse discharge coordinator or assessment officer will manage the arrangements.

It can take several days to plan a discharge, especially if a number of different services need to be arranged.


Planning the care you need

The care planned for you will depend on your needs. It is important that you and your family members or carers are involved as much as possible in these plans. Your everyday routines may change after your stay in hospital and you may find it harder to manage at home than you were expecting.

While you’re in hospital, the healthcare team looking after you will ask you questions. This is so they can assess your needs and find out what support you may need when you go home. This is often called a needs assessment. Your views and concerns are important, and you will be encouraged to be involved in the assessment.

Questions you may be asked include:

  • Do you have someone who can take you home from hospital?
  • Do you live alone?
  • Do you have relatives or friends who can help you when you get home?
  • Can you manage steps or stairs?
  • How do you manage with personal care, such as bathing and washing?
  • Can you prepare your own meals?
  • Do you need any financial support?
  • Do you have any pets that need looking after?

You will be asked for your permission (consent) before the assessment takes place. You’ll also be asked if the information can be shared with other healthcare professionals and organisations.

If you don’t feel confident understanding or speaking in English, the hospital may be able to arrange for an interpreter to be there when you meet the healthcare team.

If you have any speech or hearing problems, you can ask the doctors or nurses to write things down. If you have sight problems, you can ask for information in large print. A family member or friend may be also be able to help you with part of the assessment.


Discharge plan

After the assessment, the healthcare team will make a plan for your discharge. This is often called a discharge plan. It may include:

  • the name of the person who is co-ordinating the plan
  • details of the treatment and support you will get when you go home
  • names and contact details of who will provide the support
  • details of when, and how often, the support will be provided
  • the name of the person to contact if there’s an emergency or if things don’t happen as they should. You should be given an out-of-hours contact number too.

Your discharge plan should be reviewed regularly to make sure that your needs are being met.

When I came home, that was the terrifying part. You miss the all-round support that you get. But they did say to me “If you have any worries, just ring us."

Hugh


Involving your carers

If you have carers or family members who will be involved in your care, it is important that they are also involved in the needs assessment and discharge planning. Caring can be hard work, both physically and emotionally, and your carers may need help to support them in their caring role when you go home.

If your stay in hospital is planned, it may help both you and your carer to go through some of the things you’re likely to need help with when you go home. You can do this before you are admitted.

People sometimes feel guilty about being a burden to their relatives or friends. But remember that support from other services means your carers will have the help they need to care for you. We have more information about going home from hospital specifically for carers.


What type of support am I likely to need?

The type of support needed will vary from person to person. It will depend on the reason you have been in hospital. Some people might go in for surgery. Others might be having cancer treatment like chemotherapy. Some people might have to stay in hospital for problems caused by cancer or its treatment. This is called symptom control.

Depending on your individual situation, you may need help with some or all of the following:

  • personal care – bathing, dressing and going to the toilet
  • domestic chores – cooking, cleaning and shopping
  • home adaptations and equipment – a raised toilet seat, shower seat, hand rails, pressure-relieving cushions or a stair lift
  • healthcare – help with dressing wounds, injections, medication or specialist support for controlling symptoms
  • emotional care – companionship or counselling
  • finances – you may be entitled to financial benefits. If you need help in applying for them, call our financial guidance team on 0808 808 00 00.


When I get home

Risk of infection

This treatment can reduce the number of white blood cells in your blood. These cells fight infection. If the number of white blood cells is low, you are more likely to get an infection. A low white blood cell count is called neutropenia.

If you have an infection, it is important to treat it as soon as possible. Contact the hospital straight away on the 24-hour contact number you have if:

  • your temperature goes over 37.5°C (99.5°F)
  • you suddenly feel unwell, even with a normal temperature
  • you have symptoms of an infection.

Symptoms of an infection include:

  • feeling shivery
  • a sore throat
  • a cough
  • diarrhoea
  • needing to pass urine often.

It is important to follow any specific advice your cancer treatment team gives you.

The number of white blood cells will usually return to normal before your next treatment. You will have a blood test before having more treatment. If your white blood cell count is low, your doctor may delay your treatment for a short time.

Wound care after surgery

When you are home after your operation, check your wounds regularly. Get an urgent appointment with your GP or tell your nurse or surgeon immediately if you have any signs of infection, such as:

  • redness, tenderness or change in colour over the wound, around the scar area, or both
  • discharge (fluid being released) from the wound
  • a fever (a temperature above 38°C or above 100.4°F)
  • uncontrollable shivering (rigors)
  • feeling generally unwell.

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