DHSC and NHS England implementation update provided to the Thirlwall Inquiry (April 2025). This is the government's own account of progress, submitted to the inquiry. Reviewed extent of implementation: Implemented – Ongoing. The Hospital Discharge Service policy and operating model (August 2020) details the discharge requirements for all NHS trusts, community interest companies, private care providers of acute community beds and community health services and social care staff in England. It is published by the Department of Health and Social Care. The guidance, based on successful discharge to assess principles, aims to ensure that all individuals are discharged from hospital in a safe, appropriate and timely way. It includes patient information leaflets for a variety of different circumstances, as well as staff action cards summarising the responsibilities of health and care staff in the hospital discharge process. Professional Guidance In 2018, the Academy of Medical Royal Colleges (AoMRC) published guidance which states that letters should be written directly to patients, copying their GP (and provides a template). The AoMRC's guidance is also reflected in National Institute for Health and Care Excellence (NICE) guidance on shared decision making. In December 2021, the AoMRC, the Professional Record Standards Body (PRSB) and NHS Employers wrote to their members to remind them of best practice when writing to patients, referring to AoMRC's guidance. In October 2021, the PRSB updated its guidance on standard outpatient letters to make it clear that it is best practice for most outpatient letters to be written directly to the patient. The GMC updated its Good Medical Practice guidance to include communicating effectively with patients. This came into effect in January 2024. Regulation The NHS Standard Contract states that outpatient letters should be consistent with PRSB's standards. All NHS and Independent Sector providers are regulated by the Care Quality Commission (CQC), and assessments include how services ensure that patients understand and are involved in decisions regarding their care. As per the Competition and Markets Authority's (CMA) Order, private healthcare providers must send letters to patients prior to consultations or further tests and treatments setting out the costs, reasons and other relevant information regarding the procedure.