Guideline 64 Annex 2: Example Discharge/Team Care Plan

Patient details

Hospital details

Hospital name
Ward name or number
Ward direct dial telephone number
Patient's named nurse
Patient's key worker
Date of admission
Date of discharge

Diagnosis(es)

In-patient investigations

Current AHPs treatment

Allied Health Professionals	Current treatment regime
Occupational therapy
Physiotherapy
SLT
Other:

Special needs

Investigations to be arranged by primary care team

Primary care investigation needed	Date for which investigation is needed	Comments

Investigations arranged as out/in-patient

Hospital investigation needed	Date for which investigation is arranged	Comments

Further hospital attendances

For details of transport arrangements, or if they are to be change contact:

Continuing care after discharge

Record of level of achievement