What to do if…
you are coordinating a hospital to hospice transfer and information is missing

What to do now

1. Name the problem clearly and ask who is leading the discharge.

   • Say: “I am being asked to coordinate a hospice transfer, but key handover information is missing. Who is the discharge lead for this patient right now?”
   • If no one is clearly leading it, ask the ward manager or nurse in charge to name one point person.

2. Ask for the minimum safe handover set in writing. Ask for:

   • the discharge summary or interim discharge letter, including diagnosis, current issues, and immediate plan
   • the current medication list, including medicines started, stopped, changed, as-required medicines, and allergies
   • resuscitation documentation, such as DNACPR, treatment escalation plan, or ReSPECT, as used locally, and how it will travel with or be accessible to the hospice
   • a symptom control plan for tonight and the next day, including pain, breathlessness, agitation, nausea, and secretions
   • whether anticipatory or “just in case” medicines have been prescribed, where they are, and who can administer or authorise them
   • ward contact details, responsible clinician details if available, and hospice admissions or clinical contact details

3. Ask the ward pharmacy or medicines team to check the medicines before transfer.

   • Say: “Can the discharge medicines list be printed or sent now, and can someone confirm what medicines physically travel with the patient today?”
   • Ask what will go with the person, what will be supplied directly to the hospice, and when.
   • If controlled drugs are involved, ask who is responsible for handover and how it will be recorded.

4. Call the hospice admissions or clinical team and do a receipt check.

   • Say: “The hospital is preparing transfer, but some information may be missing. What must you have before arrival to receive safely?”
   • Read out any uncertain items, especially medicines, allergies, resuscitation documentation, symptom plan, equipment, and transport timing.
   • Ask: “Can you accept safely without this, or should the hospital pause until it is provided?”

5. Confirm equipment and transport as facts, not assumptions.

   • Ask for the transport provider, pickup time, destination, and whether an escort is needed.
   • Ask whether any bed, oxygen, pressure mattress, syringe driver, commode, or other equipment is needed before arrival.
   • If equipment is missing, ask the hospice whether it can still receive the person safely or whether the transfer should pause.

6. Write down the out-of-hours plan before the person leaves hospital.

   • Ask the hospice: “Who do we call first tonight if symptoms worsen?”
   • Ask whether there is a hospice clinical number available out of hours.
   • Ask what to do if the hospice cannot be reached.
   • Use the local urgent NHS route for urgent medical help that is not life-threatening; in many UK areas this is 111. Use 999 for a life-threatening emergency.

7. Escalate calmly if the transfer is being pushed without safety basics.

   • Ask for the ward manager, nurse in charge, discharge lead, site manager, or bed manager.
   • Ask for PALS, or the hospital’s patient advice or concerns team if it uses another name.
   • Use this line: “I am not refusing discharge. I am asking for the basic information the hospice needs for a safe handover.”