The National Institute for Health and Care Excellence (NICE) has published a new national guideline entitled “Transition between inpatient hospital settings and community or care home settings for adults with social care needs (NG27)”. This guideline covers patient transitions of care; including admission to, and discharge from, hospital.
Improvements in the coordination of health and social care services are suggested, with recommendations such as providing patients and their families and / or carers with information about their diagnoses and treatment; with a complete list of their medicines upon transfer between hospital and home (or care home). Section headings include:
- Person-centred care and communication and information sharing.
- Before admission to hospital including developing a care plan and explaining what type of care the person might receive.
- Admission to hospital including the establishment of a hospital-based multi-disciplinary team.
- During hospital stay including recording medicines and assessments and regularly reviewing and updating the person’s progress towards discharge.
- Discharge from hospital including the role of the discharge coordinator.
- Supporting infrastructure.
- Training and development for people involved in the hospital discharge process.
- Implementation: getting started.
- Recommendations for research.
This guideline was developed by the NICE Collaborating Centre for Social Care; which is a partnership led by the Social Care Institute for Excellence (SCIE).
Transition between inpatient hospital settings and community or care home settings for adults with social care needs: guidance [NG27]. London: National Institute for Health and Care Excellence, December 1st 2015.
There is an associated “map of medicine” style NICE Pathways online version.