Home from Hospital - High Peak District
Phone contact number
Which hospital is the patient based ?
When is the patient due to be discharged?
Patients full name
Street Address Line 2
State / Province
Postal / Zip Code
NHS number - required when contacting GP
date of birth
Please list patient conditions
Patient Pathway - please select on discharge
0- going home with no support
1- going home with support
2- temporary bed setting e.g. rehab
3- complex needs will require additional support
Is there a home care package?, known to Adult Social Care?
Named Social Worker - if applicable
Support required post discharge - please add as much detail as you can
Safeguarding, Health and Safety and Key Information - Are there any Safeguarding concerns or markers on Systm1 or EMIS that we need to me made aware of?
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