The Right to Refuse Discharge from Hospital Explained

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Important takeaways:

• Creating a well-structured hospital discharge plan is a key aspect of effective care
• Patients do not have the right to refuse discharge from hospital
• A good hospital will not discharge someone unless it is safe to do so

Understanding hospital discharge process

Once a patient is admitted into hospital, their treatment plan – including any details for discharge or transfer – will be developed and discussed with them. 

A discharge assessment will determine whether a patient needs more care after leaving hospital. Patients should be fully involved in the assessment process, and with their permission, family or carers will be kept informed and given the chance to contribute. 

The hospital team will consider the support required by a patient in the community, refer the patient to these services and liaise with the services to manage the patient’s discharge. 

Poor discharge planning leads to poor patient outcomes and delayed discharge planning can cause patients to remain in hospital longer than necessary, taking up valuable inpatient beds when they could be more easily and comfortably cared for in the community

Each hospital will have its own discharge policy, and a hospital’s ward manager or Patient Advice and Liaison Service (PALS) in England and the Patient Advice and Support Service (PASS) in Scotland should be able to give you a copy. 

If a patient’s discharge assessment shows they will need little or no care, it’s a minimal discharge. If a patient needs specialised care after leaving hospital, their discharge or transfer is a complex discharge.

But can you refuse to leave hospital?

Reasons for refusing hospital discharge

Can you refuse to be discharged from hospital in the UK? Patients may be reluctant to leave hospital if they’re worried about how they will be cared for following their discharge – but patients do not have the right to refuse discharge from hospital. 

If a patient wishes to reject a proposal for alternative care, they often have worries and concerns around: 

• The level of ongoing care they will require
• A perceived or actual shortage of resources in the community
• Family, social or environmental factors
• Psychological or psychiatric illness
• A perception that they will be at risk if discharged

A hospital cannot discharge the person they care for, if they have no place to go. This is an unsafe or premature discharge; hospitals need to discharge patients to a safe place.

Patients refusing discharge from hospital need to know they will be looked after once they leave hospital. This is why a well-designed discharge plan helps put patients at ease.

Legal rights and hospital discharge

As a patient, do you have a right to refuse discharge from hospital? According to court cases in 2004 and 2015, hospital patients are unable to refuse hospital discharge.

Before a hospital discharge can be agreed upon, the discharge team will be responsible for making sure that basic discharge needs are met. These include: 

• Suitable clothes to wear home
• Someone picking you up (or a taxi/hospital transport is booked)
• Enough money to help in the short-term
• Knowledge and confidence in using new medical equipment
• Incontinence supplies if needed
• Support with letting the GP know about their discharge

Dealing with premature discharge

Patients and loved ones may wonder what happens if you refuse to leave hospital? First and foremost, it’s important to uncover why a patient wants to refuse discharge from hospital.

Is it because they feel it is an unsafe or premature discharge where they are being released from a hospital too early or without proper onward care arrangements? This can lead to complications during recovery, which can negatively impact health and may also increase the chances of a preventable readmission. 

If you feel you are being discharged from the hospital too soon, you have the right to appeal. Although there are different appeals processes, you would ultimately need a healthcare provider to explain why an extended stay is a medical necessity.

Reablement and post-discharge support

Creating a well-structured hospital discharge plan is a key aspect of effective care.

Many patients will have ongoing care needs that must be met in the community. Ongoing care comes in many forms, including:

• The use of specialised equipment at home such as a hospital-type bed
• Daily support from carers to complete the activities of daily living
• Regular visits from district nurses to administer medication

There is a wide variety of care available in the community, but it needs to be planned in advance of the patient’s return home, to ensure that there is no gap in their care between discharge from hospital and the start of community services.

Information about the patient must be handed to the community team so an informed plan of care will be put in place.

Reablement care helps a patient relearn how to do daily activities, like cooking meals and washing, once they have left hospital.

Normally, people who receive this care do so for around 1 or 2 weeks – but you can get free, short-term care for a maximum of 6 weeks; it all depends on how soon someone can cope at home.

Patient and family perspectives

A good hospital will not discharge someone until everything is in place, but you may wonder, ‘Can I refuse to have my husband home from hospital?’

A spouse or family member has the option to refuse to take someone home if support is not provided quoting an unsafe discharge. However, patients and their families cannot refuse a hospital discharge if theirafter care needs can be met in the community.

The role of PALS and PASS

PALS or PASS can help people in many ways, including resolving any questions or concerns you may have when using the NHS service.

PALS can:

• Help you with health-related questions
• Help resolve concerns or problems when you’re using the NHS
• Tell you how to get more involved in your own healthcare
• Give you information about the NHS complaints procedure, including how to get independent help if you want to make a complaint

• Give information about support groups outside the NHS

You can find your nearest PALS office on the NHS website, or you can ask your GP surgery, hospital or phone NHS 111 for details.

PASS is delivered by Citizens Advice in Scotland; they provide information about your rights and responsibilities when using NHS services. It’s free, accessible and confidential and can be used by patients, their carers and their families.

PASS can help you provide feedback, comments, concerns or complaints about the NHS.

To contact PASS :

• Visit the PASS website and use webchat
• Phone the PASS national helpline 0800 917 2127
• Go to your local citizens advice bureau

Escalating a discharge-related complaint

If you’re not happy with an NHS service, for example hospital discharge, you can make a complaint.

You should complain to the person or organisation providing the service first i.e. the hospital; you can then contact your local integrated care board (ICB).

However, if the NHS has not resolved your complaint, you can escalate it to the Parliamentary and NHS Ombudsman.

Human rights in hospital discharge

Patients do not have the right to remain in hospital longer than required.

However, patients have human rights entitlement with hospital discharge. Patients have the right to respect for private life and not to be treated in an inhuman or degrading way.

 Hospitals therefore need to ensure any proposed transfer or discharge is appropriate for the patient and in line with human rights legislations.

Discharging yourself from hospital

Discharge against medical advice (DAMA) can be described as when a ‘patient chooses to leave the hospital before the treating practitioner recommends discharge.’

But can you be stopped from discharging yourself from hospital? The answer is no, and patients have the right to discharge themselves from hospital at any time during their stay.

Many hospitals have a self-discharge policy which should be followed. The main concern is often whether a patient has the capacity to make a decision about their own discharge and whether there is a risk of harm to the patient if they are allowed to leave.

Frequently asked questions

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