Covid-19 guidance: hospital discharge service requirements action required

New guidance on hospital discharge service requirements provide actions that must be taken immediately to enhance discharge arrangements and the provision of community support.

Last Thursday saw the publication of COVID-19 hospital discharge service requirements.

This is an important read for Acute Trusts, Community Trusts and Care Home Providers.

Its guidance is clear and stark in order to free up 15,000 beds within a week.

Acute and community hospitals must discharge all patients as soon as they are clinically safe to do so. Transfer from the ward should happen within one hour of that decision being made to a designated discharge area. Discharge from hospital should happen as soon after that as possible, normally within 2 hours.

The Government has agreed the NHS will fully fund the cost of new or extended out-of-hospital health and social care support packages, referred to in this guidance. This applies to people being discharged from hospital or who would otherwise be admitted into it, for a limited time, to enable quick and safe discharge and more  generally reduce pressure on acute services.

In order to assist with this, the existing North of England Commissioning Support (NECS) care home tracker will be extended to cover all care home places, all NHS community hospital beds and hospice beds. All providers must sign up and start using the tracker by today: Monday 23rd March 2020.

Further information on the actions that must be taken are set out in :

  • Chapter 3 for Acute Trusts
  • Chapter 4 for Community Trusts
  • Chapter 5 for Adult Social Care
  • Chapter 6 for CCGs
  • Chapter 7 for the Voluntary Sector
  • Chapter 8 for Care Homes

Funding information is set out in Chapter 10 covering procurement, contracting etc.

The guidance emphasises that duties under the Mental Capacity Act 2005 still apply during this period. So, if a person is suspected to lack the relevant mental capacity to make the decisions about their ongoing care and treatment, a capacity assessment should be carried out before a decision about their discharge is made. Where the person is assessed to lack the relevant mental capacity and a decision needs to be made then, there must be a best interests decision made for their ongoing care in line with the usual processes. The guidance goes on to state that if the proposed arrangements amount to a deprivation of liberty, Deprivation of Liberty Safeguards in care homes arrangements and orders from the Court of Protection for community arrangements still apply but should not delay discharge – which we are not sure will be possible but let’s see!

This is an evolving situation.  

Please do not hesitate to contact any of our healthcare team at any time.

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