10 Principles for Complex Discharge: Guidance & Toolkit

Guidance and toolkit from WellChild and the Pan Thames LTV Collaborative to support health and care professionals to improve practice for all children and young people requiring a complex discharge from hospital to home and beyond.

Following the success of the 11 Principles for Better Training project the WellChild Nurses, a network of 50 specialist children’s nurses from across the UK and Northern Ireland, identified the national need for something similar to be created for the area of complex discharge from hospital to home.

The Pan Thames LTV collaborative, a collaboration between the South Thames Paediatric Network, the North Thames Paediatric Network and Paediatric Pan London Long Term Ventilation Group brings together the skills and knowledge of clinicians and commissioners from across London and the South East of England who have extensive experience in working with children with complex needs.

It is acknowledged that complex discharge is carried out differently depending on where you are in the UK and who or what is available to support the process. WellChild and the Pan Thames LTV collaborative recognised their joint aims to improve family experience and came together to co-produce this project.

What is it?

The project comprises three key elements to support professionals working to discharge children and young people home from hospital.

  1. The 10 Principles for Complex Discharge – guiding principles for what to consider at each stage of the discharge process.
  2. Discharge guidance and toolkit – information, templates, forms to be used at each stage of the discharge process.
  3. Useful existing references or resources – other useful information around discharge to support professionals.

Although available separately all three elements are designed to be used together to aid best practice.


The aim of WellChild, Pan Thames LTV collaborative and associates is to ensure that children and young people with complex needs get the right care at the right place and time. In situations where children do spend time in hospital, our purpose is that this will be a useful reference framework to give clinicians the information and tools to ensure that there is a consistent, safe and timely approach to discharge. 

The content of this framework is a consensus of nurses and therapists actively leading and supporting children, their families, and other professionals through complex discharge pathways.

Tracking use and implementation

The Pan Thames LTV Collaborative is conducting a pilot on the implementation of the reference guide and resources across the Pan Thames region.

To evaluate the impact of this project, we are keen to hear from anyone using the documents from the Discharge Guidance Toolkit. We aim to gather information on who is using the documents, which ones are most useful, and how they impact clinical practice for both professionals and families.

You can provide feedback by completing the following survey: Tracking use and implementation – Discharge Guidance Toolkit, Survey 1 (jisc.ac.uk)

Your details will only be used for the purposes of this project. As this is part of a collaboration your details may be shared with the South Thames Paediatric Network and North Thames Paediatric Network where relevant. By completing the survey you are consenting to sharing your data with the parties involved in this collaboration. All other principles governing the UK GDPR will be adhered to by both parties. Please see our privacy policy here >>

Discharge reference guide and tools

To edit a document you will need to download it and open in Adobe Acrobat. You can then save a version to your system.

Appendix H: Paediatric Respiratory Action Plans (Tracheostomy LTV & NIV/CPAP) from PPLLTV Group. Click here >>

These documents are up to date at the time of publishing.

  • Guidance for completing Appendix H: Paediatric Respiratory Action Plans (Tracheostomy LTV & NIV/CPAP) from PPLLTV Group. Click here >>
  • Paediatric Pan London Oxygen Group Documents
    • Home Oxygen information Leaflet. Click here>>
    • Discharge bundle – 7 separate documents to aid the safe and timely discharge of a child requiring home oxygen across Greater London. Click here>>
  • Compiled by the Occupational Therapy department in collaboration with the Child and Family Information Group Moving home when your child is on long term ventilation with a tracheostomy: information for families >>

Ref: 2017F2078 April 2021 © Great Ormond Street Hospital for Children NHS Foundation Trust

  • Housing and hospital discharge early planning document. Click here >>
  • Occupational therapy long-term ventilation (LTV) information pack. Click here >>

© 2019 Guy’s and St Thomas’ NHS Foundation Trust


ACP | Advanced Care Pathway
DGH | District General Hospital
ENT | Ear Nose and Throat
GOSH | Great Ormond Street Hospital
GP | General Practitioner
MDT | Multi-Disciplinary Team
NGT | Naso-Gastric Tube
NICU | Neonatal Intensive Care Unit
PSP | Patient Specific Protocol
SALT | Speech and Language Therapy
CYP | Child/Young Person, Children/Young People
LTV | Long Term Ventilation
NIV | Non-Invasive Ventilation
TrLTV | Tracheostomy Long Term Ventilation

Contact details

If you have difficulties accessing the above resources, contact Dunni

[email protected]