Care Transfer Hub

A Care Transfer Hub is a focal point for coordinating discharges from Admitted Patient Care for PATIENTS with new or increased health and care needs, and who require post-discharge health and/or social care support.

A Care Transfer Hub manages discharges for PATIENTS on Discharge Pathways 1, 2 and 3.

PATIENTS who are likely to have complex discharge needs are referred to a Care Transfer Hub by CARE PROFESSIONALS or other staff from the WARD in which the PATIENT is residing. The WARD staff should begin discharge planning from the point of admission, and must provide relevant information about the PATIENT's prospective needs to the Care Transfer Hub. Care Transfer Hub staff determine the most appropriate Discharge Pathway, taking a 'home first' approach.

Care Transfer Hubs may operate at NHS Health Care Provider, Integrated Care Board lower-level geographical site ('place'), or at Integrated Care System level, to support local needs most effectively. Each Care Transfer Hub should comprise a multi-disciplinary and multi-agency team of health, social care, housing and voluntary sector partner ORGANISATIONS, with strong links into Health Care Providers.

'Place'-based ORGANISATION partnerships often (although not always) match the  GEOGRAPHIC AREA covered by a County (upper-tier) Local Authority or Unitary Authority. This means that in many areas, 'place' is the level at which most activity to join up budgets, undertake planning and decide pathways for health and social care SERVICES should happen.

Further information on Care Transfer Hubs can be found in the NHS England website at: NHS England - UEC recovery plan delivery and improvement support.