An TCF discharge or transfer letter hands a patient's ongoing care to the next professional, such as a community nurse, a GP or a care home. A Grade B letter says in the first sentence that the patient is being discharged and what care they need, then gives only the current information that care depends on. The admission story matters much less than what happens next.
Discharge letter vs referral letter
| Referral letter | Discharge or transfer letter | |
|---|---|---|
| Purpose | Ask the reader to assess or treat a problem | Hand over care as the patient leaves your service |
| Focus | The problem, findings and history | Current condition, care needs and follow-up |
| Typical reader | Specialist, allied health professional | Community nurse, GP, care home, rehabilitation unit |
| Typical request | "Assess and manage..." | "Continue wound care, monitor..., arrange..." |
What the next carer needs to know
- Why the patient was admitted, in one sentence, and the date of any procedure.
- Current status: wound, mobility, pain, continence and cognition, whichever apply.
- Medication changes, especially new medication they must give or monitor.
- Education already given to the patient or family, so it is not repeated or contradicted.
- Home and support: who is at home, and equipment in place.
- Exactly what you are asking them to do, and when.
TCF discharge letter template
[Recipient's name and position]
[Organisation and address]
[Date]
Re: [Patient's full name], DOB [date of birth]
Dear [Title and surname / Sir or Madam],
Paragraph 1: purpose. I am writing to inform you of [Mr/Ms surname]'s discharge [home / to your facility] on [date], following [reason for admission or procedure], and to request [main ongoing care].
Paragraph 2: current condition. [Wound, mobility, pain and other relevant status on discharge].
Paragraph 3: medication and education. [New or changed medication]. [What the patient or family has been taught].
Paragraph 4: home situation. [Support at home, equipment, risks].
Paragraph 5: request. I would be grateful if you could [visits, checks, removals, monitoring]. [Follow-up appointment already booked].
[Yours sincerely / Yours faithfully],
[Your name]
[Your role and ward]
Worked example: nursing discharge letter
- Patient: Margaret Ellis, 74, retired shop owner, lives with husband (82, frail)
- Admitted 9/9 with fractured neck of left femur after fall at home; hemiarthroplasty 10/9
- Wound: clean, dry, 14 clips, due for removal 22/9
- Mobility: walking frame, supervision on stairs; OT home visit done, rails fitted
- Meds: new enoxaparin 40 mg SC daily until 8/10; paracetamol 1 g QID PRN
- Daughter taught enoxaparin injection, competent; lives 5 minutes away, visits daily
- Hobbies: gardening, choir. Cataract surgery 2019
- Fracture clinic appointment 1/10
District Nursing Team
Northgate Health Centre
2 Station Street
Northgate
16 September 2026
Re: Mrs Margaret Ellis, aged 74
Dear Sir or Madam,
I am writing to inform you of Mrs Ellis's discharge home today, following a left hip hemiarthroplasty for a fractured neck of femur, and to request wound care and monitoring.
Her surgery was performed on 10 September after a fall at home. The wound is clean and dry, and the 14 clips are due to be removed on 22 September.
Mrs Ellis now walks with a frame and needs supervision on stairs. An occupational therapy home visit has been completed and rails have been fitted.
She has been started on daily subcutaneous enoxaparin 40 mg until 8 October. Her daughter has been taught to give the injections and is competent to continue them at home. Mrs Ellis may take paracetamol 1 g up to four times a day for pain as required.
As her husband is also frail, her daughter, who lives nearby and visits daily, will be her main source of support.
I would be grateful if you could remove the clips on 22 September, monitor her wound and mobility, and reinforce falls prevention advice at home. She has a fracture clinic appointment on 1 October.
Yours faithfully,
Alex Morgan
Registered Nurse, Orthopaedic Ward
Why it works: the gardening, choir and old cataract surgery are left out because they do not change her care at home. The clip removal date, anticoagulant and support situation are kept, because the district nurse acts on each of them. Because the letter is addressed to a team, not a named person, it closes with "Yours faithfully".
Common discharge letter mistakes
- Retelling the whole hospital stay day by day.
- Leaving out the date of a clip removal, dressing change or follow-up appointment.
- Not saying who has been taught what, so the reader repeats or contradicts it.
- Ending with a vague request instead of specific tasks.
Practise discharge and transfer letters with instant feedback against all six criteria in the Exam Hero TCF question bank.
