Discharge PractitionerNHS

Job summary

The Discharge Practitioner is a key operational and patient-facing role within the integrated Flow Optimisation function. The role sits with the integrated Bed Flow and Discharge service to strengthen operational coordination, discharge ownership, and system-wide flow.

The postholder will work closely alongside Senior Discharge Practitioners, Bed Flow Teams, Delegated Commissioning, Housing Support Leads, inpatient multidisciplinary teams, Home Treatment Teams (HTT), Community Mental Health Recovery Services (CMHRS), and Local Authorities to proactively progress discharge pathways and reduce delays.

The role will provide day-to-day coordination of discharge activity across allocated wards within Silverwood and Farnham Road Hospital while supporting Senior Discharge Practitioners with oversight and progression of contracted and out-of-area beds. A strong visible ward presence and in-person working are core expectations of the role to ensure real-time engagement with ward teams, timely escalation of issues, and active progression of discharge plans.

The postholder will support patients with complex discharge pathways, clinically ready for discharge (CRFD) status, and long length of stay (LLoS), ensuring barriers are identified early and actions are progressed promptly. The postholder will be primarily hospital based at either Farnham Road Hospital or Silverwood and will provide support across inpatient wards, contracted beds, and discharge pathways as required.

Main duties of the job

The Discharge Practitioner will support the coordination and progression of safe, timely and effective discharge pathways across allocated inpatient wards, taking ownership of actions required to progress discharge plans from admission through to discharge. The postholder will work closely with inpatient MDTs, Bed Flow, Senior Discharge Practitioners, HTT, CMHRS, Housing Support Leads, Delegated Commissioning, Local Authorities and external providers to identify and resolve barriers to discharge. They will maintain oversight of patients who are Clinically Ready for Discharge (CRFD), have a Long Length of Stay (LLoS), or have complex discharge needs, escalating delays appropriately. Duties include attending ward rounds, MDT and discharge meetings; coordinating referrals and community follow-up; supporting 72-hour follow-up arrangements; undertaking home visits where appropriate; maintaining accurate SystmOne records; tracking discharge actions and expected discharge dates; supporting contracted and out-of-area placements; and contributing to service improvement, audits and operational escalation processes.

Job description

Key Responsibilities

Discharge Coordination and Patient Flow

• Support the coordination and progression of discharge pathways across allocated inpatient wards.
• Take ownership of actions required to progress patient discharge plans from admission through to discharge.
• Work collaboratively with ward teams, community services, HTT, CMHRS, Housing Support Leads, Delegated Commissioning, and Local Authorities to support timely discharge.
• Maintain oversight of patients who are clinically ready for discharge (CRFD) and escalate delays appropriately.
• Support the identification and progression of patients with long length of stay (LLoS) and complex discharge barriers.
• Ensure discharge planning is embedded from the point of admission and remains visible throughout the patient journey.
• Attend ward rounds, discharge meetings, MDT discussions, and locality meetings to support discharge progression.
• Support the implementation of Trust discharge and patient flow processes and standard operating procedures.

Clinical and Operational Responsibilities

• Support Senior Discharge Practitioners in maintaining oversight of contracted and out-of-area placements.
• Ensure discharge actions, expected discharge dates, and escalation plans are accurately documented and progressed.
• Liaise with HTT and CMHRS teams to support safe and coordinated discharge arrangements.
• Support arrangements for 72-hour follow-up appointments and ensure follow-up plans are clearly documented.
• Support patients transitioning to community settings by coordinating referrals and follow-up actions.
• Conduct home visits where appropriate to support discharge planning, assess discharge environments, identify potential risks or barriers, and support smooth transitions from inpatient care to community settings.
• Escalate discharge barriers and operational concerns in a timely manner.
• Support implementation of actions during periods of operational escalation, including OPEL escalation processes where required.
• Manage and reconcile the Trust credit card in accordance with Trust financial policies and procedures

Communication and Partnership Working

• Establish and maintain effective communication with patients, carers, relatives, ward staff, community teams, housing providers, Local Authorities, and external agencies.
• Communicate sensitive and complex information in a professional and compassionate manner.
• Work collaboratively across organisational boundaries to support effective discharge planning and continuity of care.
• Build positive working relationships with system partners to support patient flow and timely discharge.

Information Management and Documentation

• Maintain accurate and contemporaneous records within SystmOne EPR and operational reporting systems.
• Ensure discharge actions, follow-up arrangements, and escalation plans are appropriately documented.
• Support collection and reporting of discharge and flow data.
• Maintain visibility of allocated caseloads and ensure actions are tracked and progressed appropriately.

Service Improvement and Quality

• Participate in service improvement initiatives aimed at improving patient flow and reducing delays.
• Support the development of effective discharge processes and operational pathways.
• Contribute to audits, operational reviews, and quality improvement work.
• Ensure compliance with Trust policies, operational procedures, and information governance requirements.

Key Working Relationships

The postholder will work closely with:

Senior Discharge Practitioners

Bed Flow Managers and Coordinators

Inpatient MDTs and Ward Managers

Home Treatment Teams (HTT)

Community Mental Health Recovery Services (CMHRS)

Delegated Commissioning Teams

Housing Support Leads

Local Authorities and housing providers

External providers and partner organisations

Working Arrangements

The role is primarily hospital based, with a visible and consistent presence expected across inpatient wards and operational meetings. In-person working is a core expectation of the role to support real-time collaboration, proactive discharge management, and effective operational flow.

About us

Surrey and Borders Partnership NHS Foundation Trust is the leading provider of mental health, learning disability, neurodevelopmental and drug and alcohol services in Surrey and North East Hampshire. We support people of all ages and are passionate about providing high quality care that is delivered at the right time as close to home as possible to help people recover and stay well.

We are one of the top 10 mental Health, Learning Disability and Community Trust to work for nationwide. Our Trust is an inclusive and supportive employer that offers a wide range of staff networks, flexible working, free parking and excellent health and wellbeing support. We also provide a wide range of opportunities to help staff develop and progress.

Surrey is a beautiful county lying just 30 minutes away from Central London and from the South Coast. Our historic market towns and bustling districts are enveloped in wonderful countryside, and our excellent road and rail networks bring the rest of the country within easy reach. For international travel, both Gatwick and Heathrow airports are nearby.

Please note that we reserve the right to close posts as soon as sufficient applications are received.

Regrettably, due to UK Home Office requirements we cannot offer sponsorship for all our job roles.

Applicants must have the right to work in the UK for the duration of the role.

We look forward to receiving your application!