Integrated Discharge Coordinator
Closing date: 04 August 2026
The Discharge Coordinator plays a pivotal role in ensuring the safe, timely, and effective discharge of patients from hospital. Working as part of the multidisciplinary team, the post holder will coordinate complex discharge plans, facilitate communication between health and social care professionals, and work closely with patients, families, carers, and external agencies to support seamless transitions of care.
The post holder will proactively identify and address barriers to discharge, ensuring that patients receive the appropriate support and services required upon leaving hospital. They will provide specialist advice on discharge processes, contribute to improving patient flow, and support the delivery of high‑quality, patient‑centred care.
The Discharge Coordinator will work collaboratively across acute, community, and social care settings to ensure compliance with national guidance, local policies, and best practice standards, promoting positive patient outcomes and reducing unnecessary delays in discharge.
Previous experience of undertaking NHS Continuing Healthcare (CHC) Nurse Assessments is highly desirable.
Job Responsibilities
- Work independently managing own allocated case load.
- Respond to referrals within 1 working day, notifying the Discharge Team Manager/Leader if not achievable.
- Work towards the specified Estimated Discharge Date (EDD) identified by the Clinical/Multi‑disciplinary Team.
- Review daily each complex patient’s progress towards discharge to determine if the plan needs to be revised.
- Prepare complex patients and their relatives for planning for discharge, emphasising assessment closer to home.
- Support ward staff and assist in coordinating patient discharge for end‑of‑life cases, liaising with partners such as Continuing Health Care, local hospices, District Nurses, voluntary sector and charitable organisations.
- Maintain the discharge database accurately and up‑to‑date to identify Delayed Transfers of Care and reasons for delay.
- Identify appropriate patients through the trusted assessment process for Discharge to Assess initiatives.
- Conduct Mental Capacity assessments in accordance with the Mental Capacity Act 2005.
- Lead and coordinate the NHS Continuing Health Care process following the national framework and local guidance.
- Provide data for the weekly SITREP report on Delayed Discharges in accordance with the Care Act 2014.
- Escalate to the Team Manager/Leader patients declining to leave an acute or community bed that require a choice directive.
- Deputise for certain aspects of the Team Leader’s role when necessary.
- Cover and rotate through all allocated areas including Acute, Community sectors and D2A care homes.
- Participate in new Trust initiatives related to the patient discharge process.
- Liaise with Infection Control and Risk Management to minimise risk during transfer/discharge.
- Respond to all verbal and written complaints per the Trust complaints procedure.
- Ensure adherence to all Trust discharge procedures and related policies.
Knowledge, Skills and Experience Required
Full understanding of the discharge process and the ability to apply knowledge and skills effectively to ensure safe and timely patient discharge.
Skill in identifying, negotiating and coordinating patient transfers to other health or social care facilities.
Promotion of integrated and collaborative working with health, social care teams and third‑sector providers.
Ability to initiate and lead patient case conferences or best interest meetings with documented outcomes.
Proficient use of computer systems; responsible for quality of recorded information.
Ability to sensibly challenge conventional thinking to prevent or resolve discharge delays.
Measurable Results Areas
- Maintain accurate written and electronic records, respecting confidentiality and security.
- Participate actively in audits related to patient discharge and whole‑system flow.
- Contribute to development of standards, protocols, care pathways and clinical audit when requested.
- Analyse data to formulate action plans that improve the discharge process.
Communications and Working Relationships
- Utilise information systems, internet, hospital intranet and results reporting to facilitate discharge.
- Maintain the discharge database ensuring all complex patients are recorded.
- Attend multidisciplinary meetings to agree goals and actions within specified time frames.
- Communicate with staff, patients, carers and relatives professionally and sensitively while maintaining confidentiality.
- Engage patient, relatives and carers by providing information, literature and guidance.
- Establish and maintain external links with all relevant stakeholders, including social care, health community teams, GPs and third‑sector organisations.
Education and Training
- Support the Discharge Team Manager/Leader in orienting new team members and developing competence in complex discharge planning.
- Provide education and training to nursing staff and multidisciplinary workers, including induction.
- Encourage an environment that supports staff ownership of the discharge process.
- Develop personal and others’ knowledge, skills and practice in discharge planning.
- Stay updated with National Legislation, Best Practice and guidance on patient discharge.
- Participate in nursing forums and relevant adult safeguarding mandatory training when scheduled.
Person Specification – Qualifications
- Registered first‑level nurse, AHP or social care professional.
- Evidence of continuing professional development in the last year.
- Mentoring and assessing qualification.
Experience
- Significant post‑registration experience in an acute hospital or equivalent/ community setting.
- Experience contributing and sustaining change.
- Experience working with electronic systems.
Skills
- Excellent communication and interpersonal skills.
- Knowledge of key legislation, best practice and health/social care policy.
- Ability to manage, prioritise and organise own workload effectively.
- Up‑to‑date knowledge in patient discharge.
- Innovative, positive, applying critical and lateral thinking.
- Ability to plan and achieve targets and meet deadlines.
- Positive role model/expert in complex patient discharge.
- Ability to sensibly challenge conventional thinking.
- Experience of multidisciplinary and collaborative working.
- Facilitates change effectively and motivates others.
- Applies research and best practice operationally.
- Demonstrates credible leadership characteristics.
Personal Qualities
- Achieves individual and team objectives.
- Enthusiasm for integrated working.
- Works autonomously and within a team.
- Commitment and self‑motivation.
- Effective teaching ability.
Other Requirements
- Understanding of relevant national strategy/policy and its relation to service.
- Commitment to maintain fitness for role.
- Understanding of workplace confidentiality.
- Good health.
- Reliable, punctual, flexible.
- Car driver with transport.
- Willingness to work across all hospital and third‑sector providers.
- Willingness to travel locally or nationally when required.
- Maintain an organised, clean working environment.
Disclosure and Barring Service Check
This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and requires a submission to the Disclosure and Barring Service for previous criminal convictions.
Address
South Warwickshire University NHS Foundation Trust, Warwickshire
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