Information Sharing and Handover Quality Across Hospital-to-Home Transitions in Domiciliary Care
Information sharing failures remain one of the most common contributors to unsafe hospital-to-home transitions. Incomplete referrals, delayed clinical information, and unclear escalation routes undermine safe starts and place both providers and service users at risk. Providers operating across homecare transitions and hospital interfaces must align handover quality with homecare service models and pathways that prioritise accuracy, timeliness, and accountability.
This article examines the operational and governance controls providers use to manage information sharing and handover quality at the hospital interface.
Why handover quality matters at discharge
Discharge decisions are often made under time pressure, increasing the risk of missing or inaccurate information. For domiciliary care providers, poor handover can result in unsafe first visits, inappropriate care planning, and rapid escalation.
Operational example 1: Structured discharge referral checks
Context: Providers receive referrals with incomplete risk and medication information.
Support approach: A mandatory referral checklist is introduced before acceptance.
Day-to-day delivery detail: Care coordinators verify mobility status, medication changes, equipment needs, and safeguarding flags before scheduling first visits.
How effectiveness is evidenced: Providers track rejected or delayed referrals and report patterns to discharge hubs.
Operational example 2: First-visit handover verification
Context: Information discrepancies are identified during initial visits.
Support approach: First visits include structured handover confirmation steps.
Day-to-day delivery detail: Staff confirm key risks and escalate discrepancies immediately to on-call managers.
How effectiveness is evidenced: Providers monitor first-visit escalations and safeguarding alerts.
Operational example 3: Managing urgent discharge changes
Context: Discharge plans change at short notice due to clinical deterioration.
Support approach: Providers implement real-time update protocols with discharge teams.
Day-to-day delivery detail: Updated information must be confirmed verbally and logged before visits proceed.
How effectiveness is evidenced: Incident logs demonstrate reduced medication and care planning errors.
Commissioner expectation: Accurate and timely information flow
Commissioners expect providers to evidence robust handover processes that support safe discharge and reduce avoidable readmissions. Clear escalation routes and documented information checks are critical.
Regulator expectation: Safe care planning and risk management
The CQC expects providers to demonstrate that care plans reflect accurate, current information. Inspectors look for evidence that providers challenge poor information quality and protect people from avoidable harm.
Embedding handover governance into daily practice
Strong providers embed handover audits, escalation logs, and feedback loops with hospitals. These controls support safe delivery while strengthening system-wide trust and reliability.