Hospital discharge: arranging the nursing handover at home
Written by Léa Marchand, State-registered nurse · · 2 min read
Reviewed on · Reviewed by Thomas Berthier
What the practice asks for, what it guarantees and within what deadlines, so a hospital discharge becomes home care with no gap: the call, the documents, the first visit, the supplies, the written report.
Key points
- A discharge is prepared in advance, not on the day: 48 hours is almost always enough, a few hours rarely is.
- Four things decide whether a handover is accepted: prescription, protocol, available supplies and an address inside the sector.
- The practice confirms feasibility the same day the request arrives, including when the answer is no — a fast refusal beats an uncertain yes.
- A written report goes to the ward and the GP after the first visit, without waiting for an incident.
Why a discharge fails, when it fails
A handover that breaks almost never breaks on clinical technique. It breaks on an administrative detail: an unsigned prescription, supplies ordered but not delivered, an address outside the sector discovered at the door, a phone number that stops answering at 5pm on a Friday.
The cost of those details lands on the patient: a day without a dressing, a delayed infusion, an avoidable return to A&E. That is why the practice treats discharge planning as care in its own right, with the same traceability requirements.
This piece therefore describes a procedure, not an intention. Every step has an owner, a deadline and written evidence.
The sequence, from first call to first visit
Five steps, none of which requires a shared software platform: a phone, a secure health messaging address and a legible prescription are enough.
01
1. The feasibility call
The ward, the social worker or the PRADO scheme calls with four facts: town, planned discharge date, type of care, expected frequency. A feasibility answer is given the same day.
02
2. Sending the documents
Discharge prescription, discharge summary, specific protocols and the GP's contact details arrive through secure health messaging — never a personal mailbox, never an unreadable photograph.
03
3. Checking the supplies
The practice checks that everything needed is prescribed and available at the pharmacy before discharge: dressings, infusion sets, sharps container, and a hospital bed where required.
04
4. The first visit
It is booked on a named slot, not a vague half-day. It lasts longer than later visits: home assessment, setting up the protocol, explanation to the patient and relatives.
05
5. The written report
Within 24 hours of the first visit, a report goes to the referring ward and the GP: what was done, what is missing, what worries us.
Stated deadlines, and what they assume
These are the practice's own deadlines, not a sector average. They assume a complete request: an incomplete one is put on hold and the sender is called back.
| Request | Response time | Condition |
|---|---|---|
| Feasibility of a handover | Same day, on weekdays | Town, discharge date and type of care stated. |
| First visit scheduled | Within 48 working hours | Prescription received and supplies available at the pharmacy. |
| Same-day discharge | Assessed case by case | Accepted if the day's round allows it, clearly refused otherwise. |
| First-visit report | Within 24 hours | Ward's secure messaging address provided. |
What the practice asks the ward for
This list fits on half a page and removes nearly every round of phone tag.
- The signed, dated discharge prescription, with frequency and duration of care
- The discharge summary or, failing that, a one-page clinical synthesis
- The exact protocol for technical care: wound, infusion, implanted port
- The name and number of someone reachable on the ward for 72 hours
- The patient's agreement and the exact address, floor and door code included
What the practice does not take on
Saying no quickly is a service. The practice declines a discharge when it falls outside the sector, when the protocol belongs to hospital-at-home or a technical platform, or when continuity cannot be guaranteed for the prescribed duration.
In that case the answer does not stop at the refusal: where we know of one, we point to another provider in the same area.
A reasoned, immediate refusal protects the patient better than an agreement in principle that collapses the night before discharge.
Working alongside hospital-at-home, SSIAD and suppliers
Hospital-at-home is delivered by an authorised structure: the practice then works alongside it, never in its place, and follows the protocol that structure defines.
A home nursing service covers long-term hygiene and monitoring for dependent people; prescribed technical procedures remain ours to deliver alongside it, with no double billing.
With equipment suppliers the rule matches the pharmacy one: we flag needs before discharge and check delivery, but we do not stand in for a supplier whose device requires their own installation.
Frequently asked questions on this page
- How far in advance should the practice be told about a discharge?
- Forty-eight working hours allow a calm first visit, a supplies check and a stable round. Below that we still assess the request, but the answer depends on the day's workload.
- Does the practice accept a discharge announced on the day?
- Yes when the day's round allows it and the prescription is already available. Otherwise we say so immediately so the ward can find another provider without losing the afternoon.
- How should discharge documents be sent?
- Through secure health messaging, the only compliant channel for named health data. Sending them from a personal mailbox forces us to ask again, which delays the start of care.
- Does the ward get feedback after the first visit?
- Yes, within twenty-four hours: the state of the home, whether the protocol is actually running, what is missing and what needs watching. The same report goes to the GP.
Terms explained
- PRADO
- The health insurance discharge support programme: an adviser arranges the first community appointments from the hospital before discharge.
- Home hospitalisation (HAD)
- A structure delivering hospital-level care at the patient's home, with its own medical coordination.
- SSIAD
- A home nursing service providing prescribed care and personal hygiene support for older or disabled people.
- Handover notes
- The written record of a visit: what was done, what was observed, what must be watched. The shared memory of the care episode.
- Prescription
- A doctor's written order stating the procedure, frequency and duration. Without it, nursing care cannot be delivered or reimbursed, apart from procedures allowed in direct access.
- MSSanté
- The French secure health messaging system, used to exchange health data between professionals, and with patients, outside ordinary email.
Official sources
What we write is based on public references you can check for yourself.
- PRADO, the return-home service after hospital admissionAssurance Maladie (ameli.fr)
- Hospital at home: framework and eligible careMinistère de la Santé
- Care pathways: questions and answersHaute Autorité de santé
This page is informational and replaces neither a medical consultation nor a prescription.