Urgent transfer from care home to hospital
As people live longer and with more and increasingly complex needs, so requests for social care support are increasing. People are frequently moving between health and social care services and their information needs to be up-to-date and available to professionals and staff at the point of care. The NHS Plan (2019) set out the digital plan for the NHS which included greater use of electronic systems and shared care records to support person-centred care.
The PRSB Urgent Transfer from Care Home to Hospital Standard sets out the information required for the care and support of a person when they are admitted to hospital from a care home in an emergency. It helps to support the NICE guidance recommendations around communication and information sharing for hospital admissions.
The hospital transfer pathway (often called the ‘Red Bag Pathway’), aims to ensure that every care home resident has a ‘red bag’ – their ‘hospital pack’, containing their personal information documents, medications, belongings, and clothes for travelling. The standard maps to the information requirements in the Red Bag initiative, and introduces additional information requirements, including a nursing summary of the care needs of the individual as well as an individual’s personal needs, wishes and preferences.
Current release
Version: V1.3 | |
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Release date | Sept 2022 |
Release notes |   |
Next release date | December 2025 – TBC |
Next release type | Standard 3 year review |
The standard | |
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Full standard – PRSB viewer |   |
Full standard – Excel |  |
Full standard – Json |   |
Supporting documentation | Description/purpose |
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Information standards notice (ISN) – not applied for | ISNs are published to announce new or changes to information standards published under section 250 of the Health and Social Care Act 2012. |
 | This document includes general implementation guidance for all PRSB standards and detailed guidance, specific to the About Me Standard. |
 | Rules for implementation of the standard. |
 | Describes the purpose, methodolgy and stakeholder engagement for developing the standard, along with the findings and recommendations for further work. |
 | Summarises the hazards which could result from implementing the standard. |
 | Details the potential hazards from implementing the standard with their risk rating and mitigation. |
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comformant partners
The following PRSB Partners have successfully achieved conformance against this standard.
About this standard
This standard sets out the clinical, demographic, and social information that needs to be available to the clinicians (and other professionals) in hospital in order to care for and support the patient during their hospital stay.
The expected benefits of implementing the standard are:
- Identifies and supports people at risk of less favourable treatment or with less access to services; for example, people with communication difficulties who may require help to access the correct advocacy and access to the necessary adjustments to accommodate their needs in hospital
- Ensures the transition is coordinated. Physical documentation often gets lost, during the transfer of the patient, it can be incomplete, and it can be time-consuming to generate. Use of electronic documentation and this standard is an enabler for achieving that objective and ssupports more integrated and person-centred ways of working, including increased efficiency for multidisciplinary teams
- Improves patient safety by having information which is needed for safe continuity of care available on a timely basis.
However, its implementation must be concurrent with a drive to increase digital maturity across care homes. Also, in order for care home staff to have access to health and social care information held in shared records, the organisation needs to be compliant with the expected standard for health and social care to hold, process or share personal data.
Scope
The standard has been designed from the perspective of the information needs of the clinicians in hospital caring for the patient, which may differ – for example between a geriatrician and a nurse working in A&E. Therefore, it is important that the information is displayed in a way that allows the different end users to be able to access the information easily and quickly (particularly in an emergency situation)
The urgent transfer from care home to hospital standard is:
- a definition of the information required by the hospital team to continue the care and treatment of an adult patient holistically when admitted from a care home to the hospital in an emergency
- applicable to urgent referrals (or transfers) from all care home types – nursing (e.g., for people with severe learning or physical disabilities) and residential
- applies to any IT system
- designed to support the digital sharing of information
The standards will have applicability to UK urgent and emergency care services including:
- Type 1 – a major emergency care department is consultant led and must be a 24-hour, seven-day service, with full resuscitation facilities and designated accommodation for the reception of patients requiring emergency care, including those arriving by emergency ambulance.
- Type 2 – a mono-specialty emergency care department is a consultant led mono-specialty (for example ophthalmology, dentistry) emergency care service, with designated accommodation for the reception of patients requiring emergency care.This may include patients arriving by emergency ambulance, depending on local arrangements.
- Type 3 – an urgent treatment centre is general medical practitioner led, open at least 12 hours every day, and offers appointments which can be booked via the NHS 111 service or a general medical practitioner referral.
The urgent transfer from care home to hospital standard is not:
- a definition of how information should be presented to professionals
- a definition of how the information should be captured / sourced
How it works
Many of the information requirements identified in the Urgent Transfer from Care Home to Hospital Standard would ideally be fulfilled by a shared health and care record with information from the source rather than the care home. This would apply, for example, to information such as history of problems or diagnoses or medications and allergies where the GP record or the hospital record would be the source of this information.
Some information, however, will need to be transferred with the person at the point of transfer such as the reason for the referral and any recent assessments or observations (not held within the shared record) that would provide baseline information for receiving professionals and including a nursing summary of the care needs of the individual and a record of over-the-counter medications.
The following is a table of the sections included in the PRSB Urgent Transfer from Care Home to Hospital standard.
| Demographic and administrative/ legal information | Referral information | Baseline information | Additional medical and social information (current and history) | Needs, wishes and preferences |
| Person demographics | Referral details (who) | Examination findings and observations
| Allergies and adverse reactions | Individual requirements (including Reasonable Adjustments, mobility) |
| GP details | Return response to | Assessments | Medication Administration Record | Care needs summary |
| Professional contacts | Presenting complaints or issues | Investigation results | Problem list | Additional support plans* |
| Personal contacts | History of each presenting complaint or issue | Procedures | About Me | |
| Deprivation of Liberty Safeguarding | Management to date
| Medications (including over-the-counter medications) | Cardio-pulmonary resuscitation
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| Safeguarding concerns | Social context | Advance statement | ||
| Risks | Anticipatory Actions | |||
| Mental Capacity Assessment | Anticipatory Medicines / Equipment | |||
| Mental Health Act or equivalent status | Preferred place of care | |||
| Consent for information sharing | Preferred place of death | |||
| Consent for treatment | Contingency plans** | |||
| Advance decision to refuse treatment | ||||
| Lasting power of attorney | ||||
| Property and equipment list | ||||
| Documents |
* This would include relevant support plans only e.g., a behaviour support plan or a moving and handling plan.
** These are plans which set out how predictable risks associated with health and wellbeing are managed if they get worse. These are often known as contingency, safety, or anticipatory plans.
Further resources
- Standards explained
PRSB’s guide to standards which sets out the purpose and benefits of using standards and how to support frontline professionals to adopt them.
- Managing incorrect information in health records – IHRIM Good Practice Guidance
Despite vigilance when filing information in records, mistakes can occur. The Institute of Health Records and Information Management has guidance to support professionals in making corrections following errors. - Conformant suppliers
Suppliers who have gained the PRSB quality mark for conformance to our standards. - www.longtermplan.nhs.uk
- NICE guidance
- NICE shared learning resource – Red bag pathway
Endorsement
- British Association for Music Therapy
- British Dietetic Association
- British Geriatrics Society
- British Psychological Society
- Care Provider Alliance
- Care Software Providers Association (CASPA)
- Chartered Society of Physiotherapy
- Compassion in Dying
- Health and Social Care Alliance Scotland
- Institute of Health Records and Information Management
- Local Government Association
- Royal College of Emergency Medicine
- Royal College of General Practitioners
- Royal College of Nursing
- Royal College of Occupational Therapists
- Royal College of Physicians
- Royal Pharmaceutical Society