Version: 1.0.0 | Published: 15 Dec 2025 | Updated: 0 days ago
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Hospital referral for assessment for community care and support

Dataset

Summary

Type:
Information standards
Applies To:
Hospital staff and community and social care staff where it is decided that that a referral for assessment is needed.
Topics:
  • Care records
  • Demographics
  • Information governance
  • Key care information
  • Patient communication
  • Pharmacy, Medicines and Prescribing
  • Referrals
  • Tests and diagnostics
Care Settings:
  • Community health
  • Hospital
  • Social care

Documentation

Description:
Hospitals must determine when it is safe to discharge a person and implement a discharge plan. Part of that decision-making process requires hospital staff to determine whether the person needs to be referred for an assessment to establish ongoing care and support in the community after discharge. This standard supports the communication between hospital staff and community and social care staff where it is decided that a referral for assessment is needed. About this standard The Hospital Referral for Assessment for Community Care and Support standard defines the information requirements in respect of an adult person being referred from hospital to health and social care for possible ongoing social and health care support following discharge from hospital. The standard includes the minimum information that previously had be sent to the person’s local authority as part of the Assessment, Discharge and Withdrawal Standard notice(s) (SCCI2075) which is now retired as well as the clinical information that health and social care professionals in the community have told us they require following discharge from hospital. Benefits:
  • Enhances professional communication and continuity of care.
  • Ensures timely access to relevant patient information.
  • Supports integrated care between acute, social and community care.
Scope The Hospital Referral for Assessment for Community Care and Support standard is:
  • a definition of the information to be shared with the responsible body when referring an adult for assessment for care and support by social services and/ or NHS services after discharge from an acute hospital
  • applicable to individuals who require care and support, after discharge, in their own home or if placed in an accommodation setting such as a care home.
  • supportive of and is an integral part of the discharge planning and process for these individuals.
  • supportive of the information elements that are needed to extract ADW notices to the local authority.
  • IT system and discharge pathway agnostic.
  • compliant with Care Act 2014 discharge pathway information requirements.
  • compatible with the Discharge to Assess process.
What is not in scope
  • the discharge processes themselves
  • all the referral information required for a person discharged from a mental health service because it is developed for a person who has received care in an acute hospital
  • adults who do not need care and support after discharge from hospital
  • people who wish to make private arrangements for care and support without the involvement of the local authority (it is recognised the local authority may still become involved for self-funded persons)
  • a definition of how information should be presented to professionals.
How it works The standard includes a core set of information that is communicated in the referral and references other important documents pertaining to the person that should be accessible. These additional documents may be communicated as attachments or be available from shared care records. For example, if an end of life care plan exists it is important that this is communicated in the referral and the recipient is sent the document or knows where to access it.
Dependencies:
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