The research project was carried out by Queen’s Nurse Candice Pellett OBE and funded by the Department of Health, and includes best practice case studies from around the country, and a number of key recommendations. Candice Pellett comments:

‘Three key themes emerged which would enable effective discharge planning: Improved communication, improved co-ordination of services and improved collaboration.

‘It is recommended that commissioners and provider organisations examine the local processes they have in place for discharge planning, ensuring that transfer of care between services is planned around the needs of patients, families and carers at all times.

‘At a practitioner level, there needs to be willingness from nurses both in hospital and community to improve partnership working, to ensure that patients, carers and families experience a seamless service when discharged from hospital to home, with good discharge planning and post-discharge support.

‘Nurses in every part of the NHS and care systems are at the heart of effective discharge planning and must continue to be the advocate for the patient the pursuit of excellent practice in transfers of care.’

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