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Recovering from illness or injury at home after a hospital stay.

First published:
15 January 2025
Last updated:

What is home first?

When your medical treatment is finished, the best place for you to recover is at home. This is known as the home first approach.

The home first approach helps you to maintain your independence as much as possible as you recover from illness or injury at home, after a hospital stay.

Home first also means that ongoing care assessments happen at home, because this is the best place to understand your longer term care and support needs.

“Home” could be in a care home, your own home or that of a friend or family member.

What are the risks of staying in hospital when you’re well enough to go home?

Staying in hospital when you’re medically well enough to go home can result in deconditioning. This can mean you lose the ability to do everyday tasks. It’s often caused by inactivity and extended periods of time in bed.

Deconditioning can: 

  • reduce your independence
  • reduce your confidence
  • reduce your muscle strength
  • increase the risk of you having poor mental health and wellbeing

Staying in hospital longer than you need to can also increase your risk of getting a new infection.

These risks could mean you need more care and support when you finally do go home. By recovering at home, these risks are reduced. Being at home can get you back to your usual routine, helping you get stronger quicker.

How does home first work in practice?

Discharge planning

Planning for your discharge starts as soon as you are admitted to hospital. The aim is to discharge you once your medical or care needs can be met at home or in the community.

The ward team will work with you and let you know when you’re ready to leave hospital. The ward team may include:

  • doctors
  • nurses
  • social workers
  • occupational therapists
  • other specialists like physiotherapists and dieticians

Your discharge plan will cover any immediate support you will need to go home. Your longer term care or support assessments will be carried out at home, once you have been able to recover further.

Don’t be afraid to ask staff about the plan to get you home. They will ensure any care you need is in place by the time you go home. Having a discharge plan is to help you get better and support you to leave hospital when the time is right.

This helps to reduce the:

  • length of hospital stays
  • risk of further deconditioning or frailty
  • risk of infections

The plan needs to include what matters to you, and this will help staff plan well. Let the ward team know if there are any issues at home that need to be resolved so there’s no delay to your discharge.

You, as well as your family members or carers, are entitled to be involved in this planning process so you know:

  • what will happen at home
  • who to contact if you need any help

Discharge options

When you are ready to go home, some discharge options are considered:

  • immediate discharge with little or no ongoing care needs
  • discharge with short term help to recover, known as reablement or rehabilitation
  • discharge with stable long term care needs, which will involve creating a plan to provide your care and support at home
  • discharge to a different short term location to a service called a ‘step down’ or ‘intermediate care’ placement, for intensive rehabilitation and reablement to prepare you to go home

Preparing to go home

There are lots of things you can do in hospital to keep moving and get ready to go home, including:

  • getting dressed each day
  • being as mobile as possible
  • using things you would usually have at home like your glasses, hearing-aid, watch and diary

Your family or friends (carers or unpaid carers) can help you while you’re in hospital. They can help you with eating, dressing and walking, if necessary. Hospital staff can show you them how do this correctly. This will help you and your carer feel more prepared when you go home.