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Registered Nurse
25-30 minutes

Standard NHS Discharge Report

The s10.ai Generic NHS Discharge Summary template is a vital resource for nurses and healthcare professionals managing patient discharge procedures in line with NHS standards. This all-encompassing template guarantees the documentation of crucial information, such as patient demographics, admission and discharge details, clinical summaries, and follow-up care plans. It is especially beneficial for recording the patient's medical history, current medications, and any necessary referrals to community or specialist services. Utilizing this template enables clinicians to deliver clear and precise discharge instructions, ensuring a seamless transition from hospital to home or another care environment. This tool is perfect for maintaining continuity of care and enhancing communication with patients and their families.

3,687 uses
4.7/5.0
J
Jordan Patel
Template Structure

Organized sections for comprehensive clinical documentation

[s10.ai Hospital]
[s10.ai Hospital Trust]
Tel: [Hospital Contact Number]
[Consultant Name]
[Consultant Department]
[Hospital Address]
DISCHARGE SUMMARY
Date: [Discharge Summary Date & Time]
Discharge Status: [Final/Interim Discharge Summary]
Name: [Patient Full Name]
MRN: [Medical Record Number]
Gender: [Male/Female/Other]
D.O.B.: [DD/MM/YYYY]
NHS Number: [NHS Number]
Home Telephone: [Patient Home Telephone]
Mobile Telephone: [Patient Mobile Telephone]
Address: [Patient Address]
Admission Date/Time: [Admission Date & Time]
Discharge Date/Time: [Discharge Date & Time]
Consultant: [Consultant Name]
Outcome: [Specify discharge outcome, e.g., discharged with consent, transferred to another facility, deceased, etc.]
Presenting Complaint: [Summarise the primary reason for the patient's admission, including symptoms or relevant medical concerns in sentence format.]
Discharging Ward: [Ward Name]
Discharging Hospital: [Hospital Name]
Discharged by: [Name of healthcare professional responsible for discharge]
Discharge Method: [Specify the discharge destination, e.g., usual place of residence, care home, transfer to another hospital, etc.]
CLINICAL SUMMARY
Admission Information
Admission Diagnosis: [List the primary diagnosis at admission, including any diagnostic codes where applicable.]
Problems
Co-morbidities: [List relevant co-morbid conditions that may impact the patient’s treatment, recovery, or follow-up care.]
All Problems
[List all confirmed and relevant medical conditions identified or managed during admission.]
Allergies
Allergies: [Document any known drug, food, or environmental allergies.]
Allergic Reactions (Selected): [List any significant allergic reactions and their severity, or state if the patient has no known allergies.]
Medications
Warfarin treatment: [Specify whether the patient was on Warfarin during admission or requires it upon discharge.]
Medications to take home: [List all medications the patient has been prescribed upon discharge, including name, dose, frequency, and duration. If applicable, confirm that TTO medications have been reviewed and are accurate.]
Discharge Plan
Advice, Recommendations and Future Plan
GP: [Specify follow-up required with GP, if any, and the reason for follow-up.]
Community/Specialist Services: [Specify any referrals made to community or specialist services, such as physiotherapy, district nursing, social care, or mental health support.]
Other Details: [Include any additional relevant details such as patient instructions, self-care advice, or special requirements.]
Signed by: [Name of the healthcare professional responsible for discharge]
Bleep/Tel: [Contact number of the discharging clinician]
Grade: [Consultant/Registrar/Other healthcare professional]
(Never come up with your own patient details, assessment, plan, interventions, evaluation, and plan for continuing care - use only the transcript, contextual notes, or clinical note as a reference for the information included in your note. If any information related to a placeholder has not been explicitly mentioned in the transcript, contextual notes, or clinical note, you must not state the information has not been explicitly mentioned in your output, just leave the relevant placeholder or omit the placeholder completely.)
(Use as many lines, paragraphs, or bullet points, depending on the format, as needed to capture all the relevant information from the transcript.)
Sample Clinical Note

Example of completed documentation using this template

s10.ai Hospital  
s10.ai NHS Trust  
Tel: 020 7946 0958
Dr. Thomas Kelly  
Cardiology Department  
123 Health Street, London, W1A 1AA
DISCHARGE SUMMARY
Date: 01/11/2024 10:00  
Discharge Status: Final Discharge Summary
Name: John Smith  
MRN: 123456789  
Gender: Male  
D.O.B.: 15/05/1970  
NHS Number: 9876543210  
Home Telephone: 020 7946 1234  
Mobile Telephone: 07700 900123  
Address: 45 Elm Road, London, W2 3RT
Admission Date/Time: 28/10/2024 14:30  
Discharge Date/Time: 01/11/2024 09:00  
Consultant: Dr. Thomas Kelly
Outcome: Discharged with consent
Presenting Complaint: Patient reported chest pain and difficulty breathing.
Discharging Ward: Cardiology Ward  
Discharging Hospital: s10.ai Hospital  
Discharged by: Nurse Sarah Johnson  
Discharge Method: Usual place of residence
CLINICAL SUMMARY
Admission Information  
Admission Diagnosis: Acute Myocardial Infarction (I21.9)
Problems  
Co-morbidities: Hypertension, Type 2 Diabetes
All Problems  
- Acute Myocardial Infarction  
- Hypertension  
- Type 2 Diabetes
Allergies  
Allergies: Penicillin  
Allergic Reactions (Selected): Rash and swelling (severe)
Medications  
Warfarin treatment: Not required  
Medications to take home:  
- Aspirin 75 mg, once daily, indefinitely  
- Metformin 500 mg, twice daily, ongoing  
- Lisinopril 10 mg, once daily, ongoing
Discharge Plan  
Advice, Recommendations and Future Plan  
GP: Follow-up appointment in 2 weeks to monitor blood pressure and glucose levels.  
Community/Specialist Services: Referral to cardiac rehabilitation program.  
Other Details: Patient advised to avoid strenuous activities for 4 weeks and to follow a heart-healthy diet.
Signed by: Nurse Sarah Johnson  
Bleep/Tel: 020 7946 5678  
Grade: Nurse
Clinical Benefits

Key advantages of using this template in clinical practice

  • Enhance your clinical documentation process with our comprehensive Discharge Summary Template, designed to streamline patient transitions and improve continuity of care. This template, tailored for [Hospital Name] under [Hospital Trust Name], ensures accurate and efficient recording of patient discharge details, including admission and discharge dates, presenting complaints, and clinical summaries. It facilitates seamless communication between healthcare providers by detailing co-morbidities, allergies, and medications, while also outlining a clear discharge plan with follow-up recommendations. By adopting this template, clinicians can enhance patient safety, optimize care coordination, and ensure compliance with healthcare standards. Explore the benefits of implementing this structured approach to discharge documentation today.
Frequently Asked Questions

Common questions about this template and its usage

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Standard NHS Discharge Report