Multi-disciplinary / multi-agency discharge teams

Coordinated discharge planning based on joint assessment processes and protocols and on shared and agreed responsibilities promotes effective discharge and positive outcomes for patients.


Some things that people have told us about what works and how to overcome the challenges

  • focus on decision-making in the right place making it a principle that assessment for long-term care should not take place in hospital
  • overcoming possible bottlenecks by not sending simple discharges to the integrated team
  • involving voluntary and community sector organisations with self-funders who may not want to talk to adult social care.