Emergency Care Discharge Standard

Nearly two million people attend emergency care services each month. Sharing discharge information between emergency care and GP practices is essential for ensuring patient safety and good ongoing treatment. Relevant and useful information must be transferred quickly to GPs and their clinical teams, reducing the risk of transcription errors and improving the patient experience.

The NHS Long Term Plan  sets out the digital plan for the NHS which includes greater use of electronic systems and shared care records to support person-centred care, ensuring clinicians have access to the information they need to provide high quality care in health services.

Current release

From 01 January 2026, this standard will be owned and managed by NHS England and is made available for reuse or amendment under the Open Government Licence v3.0 (OGL 3.0). A review of the ongoing requirement for this standard will be undertaken by NHS England. Details on this and any update to the standard will be published on the NHS Standards Directory. If you have any questions or feedback relating to this standard, please email: england.standards.assurance@nhs.net.

 

About this standard

The standard defines the information content and structure that should be used to create an emergency care discharge. It is designed for sending coded and structured electronic discharges which can be transferred to primary care and other systems and used to populate their record systems. Full electronic transfer will improve safety through reducing the risk from re-typing information and make that information fully available in the receiving electronic record systems more quickly. It can also be used for paper or electronic documents, although some of the benefits will not be realised in doing this.

The expected benefits from implementing the standards are:  

  • Improved patient safety by:
    • having information which is needed for safe continuity of care available on a timely basis
    • avoiding transcription errors when medication information is electronically transferred to the GP record (following clinician review), without the need for re-entry.
  • Improvements to patient care and patient satisfaction by:
    • having consistent and timely information (including medications, diagnoses, procedures and allergies) transferred to all relevant care professionals and their GP practice  
    • providing patients with legible up to date information about their stay in hospital.
  • Support for new more integrated and person-centred ways of working, including:
    • increased efficiency for multidisciplinary teams by providing structured and coded information on diagnoses, procedures and medications which can be reused for new ways of integrated working across health and care.
  • Time savings for NHS organisations by:
    • Avoiding the need to re-type information into the GP record
  • Increased opportunity for future development of patient led care by ensuring interoperability between multiple systems, including personal health records. 

The standard is evidence based and developed through extensive consultation with clinicians, professionals and people across health and care involved with hospital discharge. Full details of how it was developed are available in the final report in the supporting documentation.  

Summary table

The hospital electronic patient record (EPR) is expected to be able to generate much of the discharge summary from information recorded in the record such as attendance details, diagnoses, procedures, medications, patient demographics and other administrative information, with the person completing the record adding other information such as the clinical summary, plan and requested actions. Some examples to help visualise the standard are shown below.  

The standard comprises 18 sections, 10 mandatory (must be included), 8 required (should be included where the information is available), 0 optional (local choice whether to include the information).  These are shown in the summary table below:

SectionDescriptionMRO*
GP practiceDetails of the GP practice where the patient is registered.mandatory
Patient demographicsPatient details and contact information.mandatory
Attendance detailsThe details of the patient contact.mandatory
Referrer detailsDetails of the individual or team who referred the patient.required
Presenting complaints or issuesThe description of the health problems and issues experienced by the patient resulting in their attendance.mandatory
Clinical narrativeA brief description of the encounter.mandatory
DiagnosesA list of the patient’s diagnoses.mandatory
ProceduresThe details of any procedures performed.required
Medications and Medical DevicesThe details of and instructions for medications and medical equipment the patient is using.required
Allergies and adverse reactionsThe details of any known allergies, intolerances or adverse reactions.required
RisksThe details of any risks the patient poses to themselves or others.required
SafeguardingDetails of any identified safeguarding concerns.required
Discharge detailsThe details of the patient’s discharge from emergency care.required
Information and advice givenA record of any information or advice given to the patient, carer or relevant third party.mandatory
Distribution listSectionrequired
Plan and requested actionsThe details of planned investigations, procedures and treatment, and whether this plan has been agreed with the patient or their legitimate representative.mandatory
Person completing recordThe details of the person who filled out the record.mandatory
Senior reviewing clinicianThe details of the senior clinician who reviewed the record.mandatory
Contact for further informationDetails of a contact who can provide further information.mandatory

Examples

To give a clearer idea of how the standard works in practice, PRSB have created the following example letters.

Endorsement

  • ADASS – Association of Directors of Adult Social Services
  • Care Providers Alliance
  • Royal College of Emergency Medicine
  • Royal College of General Practictioners
  • Royal College of Nursing
  • Royal College of Occupational Therapists
  • Royal College of Physicians
  • Royal College of Psychiatrists
  • Royal College of Radiologists
  • Royal Pharmaceutical Society
  • Institute of Health Records and Information Management
  • Tech UK