Hospital Discharge Care in Lewisham

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Hospital Discharge Care in Lewisham

If someone you care about is being discharged from University Hospital Lewisham and you need home care arranged quickly, you are not alone. Hospital discharge often happens faster than families expect, and the pressure to have support in place — sometimes within 24 to 72 hours — can feel overwhelming. This page covers what hospital discharge care looks like in Lewisham, how the local system works, and how to find a CQC-registered agency that can start promptly.

Hospital discharge care means a carer visits your relative at home to help with the things they cannot yet manage independently: personal care such as washing and dressing, medication prompts, meal preparation, mobility support, and keeping a watchful eye on recovery. It is not medical treatment, but it can make the difference between a safe return home and a longer hospital stay or an emergency readmission.

The NHS has a clear expectation that people are discharged from hospital as soon as they are medically stable [8]. This puts the responsibility on families to have arrangements in place quickly. In practice, the ward team, a discharge coordinator, or a social worker may help, but the system is under pressure and families often need to act in parallel rather than waiting for referrals to complete.

CareAH is a marketplace that connects families to CQC-registered home care agencies across Lewisham and the surrounding area. There are around 86 CQC-registered home care agencies operating in this area [4], which gives families real choice — but also means it can be hard to know where to start. The sections below are designed to make that process quicker and clearer.

The local picture in Lewisham

University Hospital Lewisham, run by Lewisham and Greenwich NHS Trust, is the main acute hospital serving the borough. It handles a wide range of admissions — from planned surgery to emergency presentations — and its discharge team works to move patients home or to community settings as soon as it is clinically safe to do so.

The NHS uses a structured framework to manage discharge, known as Discharge to Assess (D2A). Rather than completing a full care needs assessment while a person is still in hospital, the approach is to discharge people home (or to a community setting) and assess their longer-term needs once they are settled [8]. This is designed to free up hospital beds and give a more accurate picture of what someone actually needs day-to-day. For families, it means care may need to start before a formal assessment is complete.

Lewisham and Greenwich NHS Trust uses a pathway model. Pathway 0 is for people who can go home without additional support. Pathway 1 covers those who need some support at home — this is where home care agencies typically become involved. Pathway 2 involves more intensive short-term care, often reablement, and Pathway 3 covers those needing 24-hour nursing or residential care.

For people discharged on Pathway 1, Early Supported Discharge (ESD) services may be available for specific conditions, helping people recover at home with coordinated community support. The discharge team at University Hospital Lewisham should be able to tell you which pathway applies and what they are arranging.

Lewisham Council has adult social care responsibilities under the Care Act 2014 [5]. If your relative qualifies for funded support, a social worker may carry out a needs assessment, but this can take time. Families often arrange private home care in the interim to avoid delays [8].

If there is a significant and complex care need, the NHS may be responsible for funding care in full through NHS Continuing Healthcare [2]. The Lewisham and Greenwich NHS Trust Integrated Care Board is responsible for CHC assessments in this area.

What good looks like

Speed matters, but so does getting the right agency. Here is what to look for when choosing a hospital discharge care provider in Lewisham.

Legal registration Under the Health and Social Care Act 2008 [6], it is a criminal offence for any organisation to provide regulated personal care in England without being registered with the Care Quality Commission [4]. This is not optional — an unregistered agency is operating illegally. Every agency listed on CareAH is CQC-registered. If you are approaching agencies independently, always verify their registration on the CQC website before proceeding.

Practical signals to look for:

  • The agency can confirm availability and a realistic start date — ideally within 24 to 72 hours of the request
  • They ask for a handover summary or discharge letter, not just a name and address
  • They are familiar with common post-hospital needs: wound care awareness, mobility limitations, medication management, catheter care (not treatment, but awareness)
  • They are clear about what their carers can and cannot do — agencies that overstate their scope are a warning sign
  • They have a named point of contact for urgent queries, including out of hours
  • They can scale visits up or down as recovery progresses
  • Their CQC rating is accessible and they can explain any areas of improvement noted in the report

Questions worth asking:

  • Have you provided care for people discharged from University Hospital Lewisham before?
  • What is your process if a carer does not show up for a visit?
  • How quickly can you start, and what do you need from the hospital team?

A good agency will answer these questions directly and without pressure.

Funding hospital discharge care in Lewisham

Paying for home care after a hospital discharge in Lewisham depends on your relative's financial situation and the nature of their care needs.

Local authority funding Lewisham Council has a duty under the Care Act 2014 [5] to carry out a needs assessment for anyone who appears to need care and support. If your relative qualifies, the council will also carry out a financial assessment (means test). Currently, those with assets above £23,250 are expected to fund their own care; those with assets below £14,250 receive full council funding; those in between may contribute on a sliding scale [1]. For current contact details and opening hours, search 'Lewisham Council adult social care'.

NHS Continuing Healthcare If your relative has a primary health need — complex, intense, or unpredictable care requirements — the NHS may fund their care in full through NHS Continuing Healthcare (CHC) [2]. A CHC assessment is separate from a local authority assessment. The Lewisham and Greenwich NHS Trust area Integrated Care Board is responsible for CHC decisions locally. If you believe your relative may be eligible, ask the hospital discharge team to initiate a checklist assessment before discharge. Free advice is available from Beacon [10].

Direct Payments If your relative receives a personal budget from the council, they may be able to take it as a Direct Payment and arrange care themselves [9].

Self-funding Many families pay privately, at least initially, while assessments are completed. This is common and does not prejudice a future funded assessment.

Questions to ask before you commit

  • 1.Can you start care within 48 to 72 hours, and what information do you need from us to confirm this?
  • 2.Are you familiar with post-discharge care needs for people leaving University Hospital Lewisham?
  • 3.What happens if a carer is unable to attend a scheduled visit — who covers and how quickly?
  • 4.Can the number or length of visits be adjusted as my relative's recovery progresses?
  • 5.What is your process for sharing updates with family members who are not present during visits?
  • 6.Is your CQC registration current, and can you share your most recent inspection report?
  • 7.What are your terms for ending or pausing care, and how much notice is required?

CQC-registered home care agencies in Lewisham

When comparing home care agencies in Lewisham for a hospital discharge, focus on three things: availability, relevant experience, and transparency. Availability means the agency can genuinely start within your timeframe — ask directly rather than assuming. Relevant experience means they have supported people with similar post-discharge needs, whether that is stroke recovery, orthopaedic surgery, or managing a long-term condition. Transparency means they are clear about what their carers can and cannot do, how they handle problems, and what is in the contract. CQC ratings give a useful baseline [4], but look at the date of the most recent inspection and read the summary rather than just the headline rating. An agency rated 'Good' with a recent inspection is generally preferable to one with an older 'Outstanding' rating where circumstances may have changed. Price matters, particularly if you are self-funding, but the cheapest option is not always the most reliable. Ask for written confirmation of hourly rates, any additional charges, and the minimum visit length. Home care agencies near me can be compared through the CareAH platform, which lists only CQC-registered providers.

  • No CQC-registered agencies found for Lewisham. Try a nearby town.

Frequently asked questions

How quickly can home care start after a hospital discharge in Lewisham?

Many CQC-registered agencies in Lewisham can begin care within 24 to 72 hours of an enquiry, provided they have sufficient information about your relative's needs. Start the search as soon as you know discharge is likely — even if the exact date is not confirmed. Having an agency provisionally agreed before discharge day avoids delays [8].

What is Discharge to Assess and how does it affect our family?

Discharge to Assess (D2A) is an NHS approach where a person is discharged home once medically stable, with care needs formally assessed afterwards rather than during the hospital stay [8]. In practice, it means your relative may come home before a full care package is confirmed. Arranging interim home care privately is common while the formal assessment catches up.

Will Lewisham Council automatically arrange home care when my relative is discharged?

Not automatically. The hospital discharge team may refer to Lewisham Council's adult social care team, but families often need to follow up actively. A needs assessment under the Care Act 2014 [5] is required before council-funded care is arranged. This can take time. Many families arrange private home care as a bridge while waiting. Search 'Lewisham Council adult social care' for current contact details.

What is NHS Continuing Healthcare and could my relative qualify?

NHS Continuing Healthcare (CHC) is fully funded care provided by the NHS for people with a primary health need [2]. Eligibility is based on the nature, complexity, and intensity of care needs — not diagnosis. A screening checklist can be completed before discharge. If you think your relative may qualify, ask the hospital team to begin the process. Free independent advice is available from Beacon [10].

What does hospital discharge home care typically include?

It typically includes help with personal care such as washing and dressing, medication prompts, meal preparation, mobility support around the home, and companionship during the early days of recovery. Carers are not nurses and do not provide clinical treatment, but they can be trained to assist with specific tasks agreed in the care plan. Confirm what is included before the agency begins.

Can we change the agency if the care is not working well?

Yes. If you or your relative are privately funding care, you can change agency at any time, usually with notice as specified in the contract. If care is council-funded, you can ask for a review of the care package and request a different provider. It is worth reviewing how visits are going in the first week and raising concerns promptly rather than waiting.

What information should we have ready when contacting a home care agency?

Have the following ready: the expected discharge date and which hospital ward your relative is on, a summary of their medical situation and what they currently need help with, their home address and details about access (key safe, stairs, etc.), any existing conditions the carer should be aware of, and whether any specialist equipment is in place. A discharge summary from the ward is useful but not always available immediately.

Is CQC registration legally required for a home care agency?

Yes. Under the Health and Social Care Act 2008 [6], any organisation providing regulated personal care in England — such as help with washing, dressing, or toileting — must be registered with the Care Quality Commission. Operating without registration is a criminal offence. You can verify any agency's registration status on the CQC website [4]. CareAH only lists agencies that are CQC-registered.

Page guidance last updated May 2026. Funding figures and council details may change — always check current information at the official source.