Hospital discharge for children

When your child leaves hospital it is imperative that arrangements are in place to ensure that he or she is medically fit for discharge and you have adequate support. This factsheet explains what to expect when your child is discharged from hospital, their entitlement to an assessment as well as continuing care and support.

Leaving hospital

Your child should not be discharged from hospital unless:

  • They are medically fit for discharge as determined by the clinical team.
  • An assessment has taken place to determine the level of support they may need to discharge them safely and to establish if your child qualifies for NHS continuing care.
  • You have been given a written care plan which sets out the support they will receive to meet their assessed needs and this support has been put in place.
  • There is a system for monitoring and if necessary adjusting the care plan to meet any change in needs.

Each hospital will have a formal written discharge policy which it must adhere to a named person responsible for co-ordinating discharge arrangements. They are often called ‘discharge co-ordinators’.

You can request a copy of the discharge policy from the ward manager or through PALS – the Patient Advice and Liaison Service. This document will contain full details about how the hospital should arrange your child’s discharge.

Discharge assessment/planning meeting

A discharge assessment is intended to look at the needs your child is likely to have when they leave hospital.

Depending upon the level of your child’s needs, the assessment may involve a number of different professionals drawn from both the health and social care sector and could include clinicians, physiotherapists, occupational therapists, speech therapists, dieticians, mental health practitioners or social workers.

As a parent, you should be fully involved in the assessment process. If you need support because you find it difficult to communicate your views you should consider seeking the support of an advocate.

Care plan

Once your child’s needs have been assessed a formal written care plan will be prepared. This should be comprehensive and personalised. It should include and detail:

  1. All community care services to be provided by your local authority. Where there is a need for ongoing care it will be subject to a means test.
  2. Reablement services – this is where short term care is required by children who no longer need to be in hospital but still need additional support during their recovery period or to help them adapt to life after an illness or acquired disability. Reablement lasts for up to six weeks and is free of charge.
  3. NHS Continuing Care – this is care fully funded by the NHS at home or in a residential setting where your child has been assessed as having a primary health need.
  4. NHS funded care – if your child has a health need but is not eligible for NHS Continuing Care, they may still be entitled to a financial contribution made by the NHS to ongoing health care needs.
  5. Rehabilitation/palliative care – your child may have a need or entitlement to rehabilitation after their hospital discharge or in certain cases, palliative care. This should be detailed in their care plan.
  6. Aids and equipment – often there will be a need for aids and equipment to help your child manage at home or in a residential setting. Whether it is a wheelchair, specialist bed, hoists or simple aids this should be included in their care plan. If a local authority has concluded your child needs this equipment it should be provided free of charge.
  7. Disabled facilities grant – It may be that adaptations will be needed to your home to make it accessible. Minor adaptations can be made up to £1,000 free of charge. In other cases your housing department may award a disabled facilities grant.
  8. Educational needs – if your child is school-going age, their educational needs also need to be considered.

Carers’ assessments

If your child is going to be cared for at home by a friend or family member they may be entitled to support from the local authority. Local authorities have a legal obligation to assess any carer who requests an assessment, or who appears to need support.

Follow up

Where your child has been discharged home with the benefit of local authority support and community care services, a review should take place within the first two weeks.

Resolving disputes

Hospital discharge is a complex process and it is essential that you are fully involved in the assessment and planning process to ensure your child’s needs are met after discharge from hospital and that all appropriate arrangements have been made.

Sadly, in some cases, all does not go to plan and people may feel that they have been let down or that inadequate care and support has been made for their child.

Each hospital will have a formal complaints procedure. The NHS constitution provides that you have the right to have a complaint dealt with efficiently and to be properly investigated. Generally most complaints can be resolved at a local level, but if not, complaints can be escalated and referred to the Parliamentary and Health Service Ombudsman.

Where it is felt that an NHS body has acted unlawfully then it is possible in certain circumstances to bring a claim for Judicial Review.

Independent advocacy

In complex cases it may sometimes be beneficial to seek the support of an independent advocate or legal representative in the assessment and planning process to ensure all necessary arrangements are put in place. We help children and their families through the discharge process, providing advice on policies and guidance on the next steps.

How Moore Barlow can help

If you require legal advice or representation, please contact our expert team.