There is a requirement in discharge planning for nurses to share information about patients with health and social care providers in the community. Nurses need to ensure they use safe communication procedures so that information is only shared with those who require it. Failing to apply good information governance processes could result in information being shared inappropriately and the breaching of a patient's right to confidentiality. Patients need to be supported and encouraged to make their own decisions; where a patient lacks capacity, the need to share information must be based on a consideration of risk and the person's best interests (this is discussed in more detail in Chapter c05: Communication, psychological wellbeing and safeguarding in the section about the Mental Capacity Act ([27])).

Delays in discharge contribute substantially to the financial and capacity pressures facing the NHS, as do readmissions (Winfield and Burns [54]). The total number of NHS hospital beds in England has more than halved in the past 30 years while the number of patients has increased significantly (Ewbank et al. [14]). Anticipating and managing potential delays via proactive planning therefore helps the NHS and other healthcare providers to use their limited resources most effectively, and, more importantly, can improve a patient's quality of life (Alper et al. [2]). Planning care for discharge and involving patients and their families is therefore important in keeping disruption to a minimum to ensure inpatient facilities are maximized and patients move in a seamless fashion back into the community.

Delayed and/or ineffective discharge planning has been shown to have detrimental effects on patients' psychological and physical wellbeing and their illness experience (Lees [18]). Additionally, evidence suggests that inadequate discharge planning in older people leads not only to adverse health outcomes but also to an increased risk of hospital readmission (Chenoweth et al. [9], Pellett [41]). Older people with dementia or other cognitive impairment are likely to experience an extended length of stay in hospital because of more complex organizational arrangements and an increase in the support needed on discharge (Challis et al. [8]). Elderly patients in acute care do not always get enough opportunity to mobilize and are highly likely to acquire ‘deconditioning syndrome’, where their bone mass and muscle strength are reduced. Up to 65% of older patients experience this type of decline during hospitalization (British Geriatrics Society [4]). This may result in increased risk of falls, constipation, incontinence, depression, swallowing problems and pneumonia (Arora [3]). Reducing this risk by implementing proactive planning to ensure timely and safe discharge is therefore paramount; nurses’ key role in achieving this is emphasized by The Queen's Nursing Institute ([44]), which suggests that nurses are ‘at the heart of effective discharge planning’ (p.35).