Rapid Discharge of a Dying Patient

This checklist is for all patients who are in or approaching the last days of life. When the patient and/or family are aware of the diagnosis and prognosis and their preferred place of care is home.

Staff responsibilities / Date/Time
Or not applicable / Sign /Print Name
Nursing Staff
Refer to discharge liaison team
Refer to specialist palliative care team
Complete Continuing Health Care Fast Track Tool / scan to CCG
Urgent referral to Therapy team for assessment
Contact District Nurse Team / Care Home - establish care needs
Discuss overnight support with District Nursing Team
Order ambulance category 1 (establish if access to home/stairs is an issue, involve patient services manager if necessary)
Inform community Macmillan nurse
Order home oxygen on HOOF form
Medical Staff
Order anticipatory drugs (including water for injection). Prescribe on Palliative Care Drug Chart. Contact patient service manager and ask for prescription to be fast tracked though pharmacy
DNACPR form completed. Ensure patient and family aware of the decision/explanation. Discuss plans with family if death occurs in transit. Document in patients notes
Emergency Health Care plans (EHCP) written for anticipated emergencies e.g. seizures/haemorrhage and discussed with patient/family/carer.
Inform GP, that the patient is coming home to die. Ask them to visit patient and inform Out of Hours Doctors
If a post mortem is anticipated discuss with the Coroner/GP. Ensure that the family is aware of the situation
Electronic Discharge Letter – Complete palliative care section
Ward Clerk
Photocopy relevant documentation, including Care of the Dying Patient Documentation; prescription sheet; Families Voice; DNACPR; EHCP; ADRT and send ORIGINAL copy with patient.
Prior to discharge NURSING STAFF ensure
Care package is in place
Equipment has been delivered and oxygen is in place if necessary
Syringe driver may/ not be needed
Contact relevant District Nursing Team /Care Home to inform that patient is on their way home
Fax information sheet to NEAS, OOH doctors and OOH nurses
Patient discharged with
Yellow envelope containing ORIGINALDNACPR, EHCP, ADRT
ORIGINAL Caring for the Dying Patient doc. if appropriate
Palliative Care drug cardex, medication and water for injection
Family Voice and “When Someone is Dying Leaflet”
Contact number sheet for 24 hours support/ assistance.
Relevant contact numbers
District Nursing Team for Hartlepool and Stockton
SPA (single point of access 24 hours per day) including weekends and Bank Holidays
Patient contact number. 01429 522500 –
Professional contact number 01429 522277
District Nurses Durham
Central contact number 0191 5692957
Monday to Friday 8.30 am to 5 pm
Out of Hours contact 111
Discharge Liaison Team
North Tees Hospital Monday to Friday 8.30 am to 5 pm
Telephone - 01642 624730
SpecialistPalliative Care Team- Stockton
North Tees Hospital Telephone number 01642383895
Monday to Friday 9am to5pm
Specialist Palliative Care Team – Hartlepool
Hartlepool Hospital Telephone number 01429 522154
Monday to Friday 9 am to5pm
Note that there is a Palliative care consultant on call out of hours that can be contacted via North Tees Hospital Switchboard 01642 617617
Hospice 24 hour Help Lines
Hartlepooland District Hospice 01429 855558
The Butterwick Hospice (Stockton) 01642607742
Northern Doctors Out of Hours
Out of Hours for Durham area call 111
Out of Hours for Hartlepool and Stockton call 111
Mental Health Team – for advice
Stockton – 01642 737321 9am to 5 pm
Hartlepool –01429 803660 9 am to 5 pm