How hospital discharge works in Scotland
Discharge planning is supposed to begin early in an admission, not on the day someone is ready to leave. In practice, families often first hear about it when a ward phones to say their relative is medically fit for discharge, which can feel abrupt when the person went in a fortnight ago and clearly cannot go home.
- 01Medically fit for discharge. The clinical team decides the person no longer needs hospital treatment. This is a medical judgement, not a decision about where they should live.
- 02Assessment. Social work and the hospital team assess what care is needed. This is the care needs assessment that unlocks Free Personal and Nursing Care.
- 03Discharge planning meeting. The person, the family, social work, nursing and sometimes therapy staff agree a plan. Ask for this meeting if nobody offers one.
- 04Financial assessment, where council funding is involved. It can run alongside the rest rather than after it, so ask for it to be started early.
- 05Placement. A home is identified, a pre-admission assessment takes place, and a date is agreed.
- 06Discharge day. Medication, equipment, transport and paperwork all need to line up. See the checklist below.
What you can reasonably expect, and what you can decline
Hospitals are under real pressure, and delayed discharge is a genuine problem for the whole system. That pressure is legitimate, but it should not translate into a family agreeing to the first available bed without proper information.
- You are entitled to a care needs assessment before discharge, and to be involved in it.
- You are entitled to enough time and information to make a considered choice about a permanent home.
- You can ask about choice of accommodation and how top-ups work where a preferred home costs more than the council rate. See our top-up fees guide.
- You can decline a placement you believe is unsuitable, and ask for the reasons for that view to be recorded.
- You can ask for an interim placement while you look properly, on the clear understanding that it is temporary and in writing.
- You can ask for an advocate. Independent advocacy is free and is particularly valuable where the person cannot speak for themselves.
How to make a good decision quickly
You may have days rather than weeks. You can still make a sound decision if you concentrate on the things that matter most and let go of the rest.
- Confirm the level of care needed now and likely within a year. Registration for both residential and nursing care avoids a second move.
- Check Care Inspectorate grades and the date of the most recent inspection for every home on the list.
- Visit, even briefly, and go in person. Fifteen minutes in a home tells you more than an hour on a website.
- Ask for the weekly fee in writing for the specific room and level of care, plus the extras list.
- Ask the home directly whether they can meet these needs, and take a straight no as a good sign about their honesty.
- Check the distance realistically. The home you can reach after work twice a week beats the slightly nicer one you will visit monthly.
- Ask whether the home can take a discharge at short notice and what they need from the ward to do it safely.
Delayed discharge, and what causes it
A delayed discharge is where someone is medically fit to leave hospital but cannot, usually for a reason that has nothing to do with their health. Knowing the common causes helps you head them off.
| Common cause | What helps |
|---|---|
| Assessment not started early enough | Ask on day two or three of the admission whether an assessment has been requested, and by whom. |
| Financial assessment running behind | Ask for it to start in parallel with the care needs assessment rather than after it. |
| No suitable placement available | Widen the geographic search slightly and consider a good home a little further out. |
| Family unable to agree | Ask for a discharge planning meeting with everyone present, and use an advocate if needed. |
| Equipment or adaptations outstanding | Confirm exactly what is required and who has ordered it, with a date. |
| Power of attorney or guardianship unresolved | Raise this immediately; it is one of the slowest issues to fix once discharge is due. |
Time in hospital when someone no longer needs to be there is not neutral. Mobility, confidence and appetite all decline quickly, particularly for older people and for anyone living with dementia. Politely pressing for progress is in the person's interest, not just the ward's.
Discharge day checklist
- Medication to take home, with a printed list and clear instructions, and confirmation the home has received it.
- The immediate discharge letter, sent to the home and to the GP, with any follow-up appointments noted.
- Any equipment needed on arrival: pressure mattress, hoist, walking aid, specialist seating.
- Transport booked, with the time confirmed to the home so someone is ready to welcome them.
- Clothing, glasses, hearing aids and dentures gathered up. These go missing on wards more than anything else.
- Named contacts exchanged between the ward and the home, in case something is queried that evening.
- A family member at the home for the arrival if at all possible, to set the room up and stay for the first meal.
Once the move has happened, our guide to moving into a care home covers the first day, the first month and how families settle in too.