Discharge to Assess (Home First)

Defined by NHS England, Discharge to Assess (also referred to as Home First, ) is a collaborative model of care "where people who are clinically optimised and do not require an acute hospital bed, but may still require care services, are provided with short-term, funded support to be discharged to their own home (where appropriate) or another community setting. Assessment for longer-term care and support needs is then undertaken in the most appropriate setting and at the right time for the person". 

Everyone should have the opportunity to recover and rehabilitate at home (wherever possible) before their long-term health and care needs and options are assessed and agreed. To this end, services that provide support with recuperation, recovery, ongoing rehabilitation, or reablement are often a key part of the Discharge to Assess model.

Professionals from all relevant services (such as health, social care, housing and the voluntary sector), should work together so that, other than in exceptional circumstances, no one should transfer permanently and directly into a care home for the first time following an acute hospital admission.

At all times, practitioners should refer to the most recent government guidance and any local protocols and pathways to ensure the model is applied as intended.

Department of Health and Social Care: Hospital discharge and community support guidance.

Hospital Discharge and Community Support: Staff Action Care - Adult Social Care Teams.

NICE guideline NG27: Transition between inpatient hospital settings and community or care home settings for adults with social care needs.

NHS England: Quick guides to support health and social care systems.

NHS England: Improving hospital discharge resources. 

Local protocols and processes can be found in the Discharge to Assess section of the local resources.