Refer before discharge where possible
Share the expected date and enough detail for service and funding checks. A referral does not confirm an appointment.
Transition home
Connect the discharge plan to the real home
A home visit can help translate ward recommendations into the person’s own rooms, stairs, furniture, walking route and support network.
A useful handover
Information to include
MoveWell is an appointment-based community service, not an urgent hospital substitute. Send the referral as early as practical and keep the interim discharge plan in place until availability is confirmed.
- Patient name, date of birth, address and primary contact
- Expected or actual discharge date and current ward or service contact
- Reason for admission, relevant procedures and current medical precautions
- Pre-admission mobility compared with current mobility
- Weight-bearing status, falls risk, cognition, communication and supervision needs
- Current equipment, equipment ordered and any unresolved access issue
- Home layout details such as steps, lift access or bedroom location
- Medication or symptom timing that affects movement sessions
- Funding, consent, handover and required reporting contacts
What happens next
From referral to communication back
Confirm the interim plan
Document who is responsible for mobility and exercise support while the community appointment is being arranged.
Complete the home assessment
The physiotherapist reviews movement in the actual environment and identifies practical next steps within scope.
Close the communication loop
MoveWell provides the agreed update to the authorised GP, hospital clinician, care manager or family contact.
Add context where it counts
Details that make the first visit more useful
Orthopaedic dischargeInclude procedure, date, weight-bearing status, movement precautions, wound-related instructions and planned surgical review.
Deconditioning or prolonged admissionDescribe prior function, current assistance level, exertional limits, falls and the daily activities needed at home.
New walking aidInclude the exact equipment issued, current setup and whether the person and family demonstrated safe use before discharge.
Complex dischargeName the lead coordinator and identify nursing, medical, occupational therapy, speech pathology or community services already involved.
Common referrer questions
Can MoveWell guarantee a visit on the discharge day?
No. Availability, location, funding and service fit must be checked. Keep the safe interim discharge arrangement in place until an appointment is confirmed.
Can the physiotherapist assess stairs at home?
Stairs can be considered when it is safe and relevant. Include the number, rail setup, current ability and any restrictions in the referral.
What if the person deteriorates after discharge?
Use the discharge escalation plan, contact the treating medical service or seek urgent care. Call 000 for an emergency. Do not wait for a website enquiry response.