Core procedures
C5Discharge
- Owner
- Admin sends. The clinician supplies the reason.
- Trigger
- A pathway completes, a warning expires and the Daily Brief decides to discharge, a patient is assessed and not diagnosed, or an anomaly arises.
Uses
Referenced by
Purpose
How a patient leaves the service, whether that is at the end of a pathway, through non-engagement, or for a one-off reason.
Procedure
- Confirm the discharge route: pathway complete, non-engagement (via C2 and the Daily Brief), no diagnosis given at assessment, or anomaly.
- For anomaly discharges - patient has moved out of area, patient does not want medication, or any other one-off reason - add to the discharge tab.
- Admin copies the reason from the clinician's notes into the discharge letter. Admin does not compose the clinical reason.
- Send the discharge letter to the patient and the GP.
- Record the outcome code and close the record (C6).
- Confirm the patient is removed from every active tracker they appear on - titration, obs, prescriptions, shared care, chase lists.
Fields recorded
NHS number · name · discharge route · reason (from clinician's notes) · date letter sent · date sent to GP · outcome code · removed from active trackers (Y/N)
Variations
No diagnosis - A patient assessed and not given an ADHD or autism diagnosis is discharged. No post-diagnostic follow-up is offered and any booked post-diagnostic appointment is cancelled.
Never-engaged new referral - Discharged directly at the end of C3. No Daily Brief review required.
Notes
- Every discharge of a patient who has engaged with the service goes through the Daily Brief first. Only never-engaged new referrals bypass it.
Open points
- Whether anomaly discharges take a different ICB outcome code from standard discharges.
- Whether removal from active trackers is manually cross-checked, and by whom.