Discharge Cards for Personalised Care

Introducing Discharge Cards for personalised, safe and timely hospital discharge

The NHS Long Term Plan sets out how Personalised Care underpins our efforts to recover services for patients, support the NHS workforce and address health inequalities.  We are delivering a programme of work to support London’s Clinical Networks and Integrated Care Systems to do this.

In 2023, we piloted the introduction of Discharge Cards as a way for address the increasing numbers of people who are healthy enough to leave hospital but can’t due to a lack of suitable support or accommodation for their recovery. This delays their discharge, and admittance for other patients, considerably impacting patient flows and individual experience.

Discharge Cards can address the low-cost issues that stop discharge. These are one-off payments, usually for £200 or less, which provide people with the initial support they need to leave hospital safely.

The Discharge Card is accessed via a payment card that is registered to named Trust staff to purchase goods or services online, or in shops. It is linked to an online account that enables easy monitoring and reporting of transactions made.

They are a safe, quick and easy route to assisting discharge and getting patients home sooner, which is vital to help avoid patient isolation, additional infection and complications.

They are considered a one-off personal health budget (PHB), which is set out in NHSE guidance: Next Steps in Increasing Capacity and Operational Resilience (Aug 2022) and One-off PHBs within Hospital Discharge Pathway (Apr 2022).

To support this work, we have developed a toolkit to help Hospital Trusts raise awareness and increase the use of Discharge Cards as a way of easing pressures through personalising care for patients. See the letter from NHS London’s Chief Nurse, and SRO for Personalised Care Jane Clegg introducing the toolkit and download the toolkit to access the electronic templates and materials to help spread the message about Discharge Cards here.

Watch this short animation that explains what a discharge card.


How does it work?

Through a conversation with the patient, family and/or carers, hospital discharge teams explore and identify support that could be accessed quickly to help get the patient home or to their usual place of residence. The card holder than uses the Discharge Card to make the small purchase.

There is advice and simple guidelines to support staff in feeling they are making the right decision to use the Discharge Card.


Which patients are eligible for the Discharge Card?

Patients on Pathways 0 or 1, and individuals not currently accessing Continuing Healthcare, therefore have low health needs, with little or no anticipated impact on primary care.


What can the Discharge Card be used on?

Purchases up to the amounts of £200.  For over £200, there is a simple process to follow to ensure sign off. When this was tested in ICBs across London, it was usually only a small amount over, e.g. £10-15 for a tradesperson to repair furniture or to arrange a delivery.

Examples of purchases include clothing, shoes, microwaves, food, beds, bedding and mattresses, mobile phones, sim cards, phone credit, locksmith services, deep cleaning services, and fridges for storing medication.


What it can’t be used on

Discharge Cards cannot be used to purchase:

  • long-term care needs following completion of a Care Act and/or NHS Continuing Healthcare assessment
  • social care or NHS Continuing Healthcare packages that are restarted following discharge from hospital at the same level as that already delivered prior to admission to hospital
  • Pre-existing (planned) local authority expenditure on discharge services.

The payment is also not for:

  • an item or service prohibited by the National Health Service (Direct Payments) Regulations 2013 (alcohol, tobacco, gambling or debt repayment, or anything that is illegal)
  • emergency acute care
  • primary care services such as seeing a GP or buying medication


How do we know Discharge Cards work?

Since December 2022, North West London Integrated Care Board (NWL ICB) piloted the use of a Discharge Card to provide the one-off payments across four acute hospital trusts. They are focused on establishing value for money and impact on patient flows and health and wellbeing outcomes.

The NWL pilot delivered 44 early discharges between January and June 2023, costing just £2,442, thanks to the Discharge Card. This saved 198 bed days – an equivalent cost of £158,400.


Examples of impact:

  • For a local system: NWL developed a successful discharge protocol for homeless patients in all eight boroughs. Inclusion health teams worked with people with complex needs who were rough sleeping. The Discharge Card helped prevent discharge back onto the street by procuring bridging accommodation, while permanent solutions were being arranged by local authority and housing association partners.
  • For an individual: Mary had a communicable disease but was well enough to be discharged. Accommodation for her was found in an area she didn’t know, so the Discharge Card procured a food voucher for an online delivery so she didn’t have to mix in the community. It also provided a stopgap until her universal credit was deposited into her bank account.
  • For a carer: Using a Discharge Card meant ordering a bed and arranging delivery for the same day as discharge. This and the paperwork could have taken over a week to sort otherwise, and the patient’s son’s mental health was not further impacted with the stress to purchase or remove the furniture.

Supporting materials

Download these materials to support the rollout of Discharge Cards in your Trust: