Discharge Support Service

  • The role of Discharge Support Service is to assist with complex discharges and to help patients make a smooth, timely and safe transition from the hospital to home.  Liaising with other health professionals to provide a coordinated approach to patient care and referring to other services such as Transition Care Program or Hospital in the Home.

    Our staff members coordinate the Short Term Support Service which provides community based services to assist people to recuperate after leaving hospital with the aim to prevent hospital readmission.  A range of community based services may be provided dependent upon the patients individually assessed needs.  The most common services provided are:

    • District Nursing
    • Home Care Services
    • Meals

    Services are arranged by PAC staff and provided for the duration of the recuperative period and are generally of a short-term nature.


    In patients within Hamilton Hospital are referred via TrakCare.  Referrals can be faxed from outlying public hospitals.