Hospital Transfer Form

Use this form when a resident needs to be transferred to hospital. It uses the SBAR (Situation, Background, Assessment, Recommendation) format recommended by NHS England and the Royal College of Physicians to ensure clear, structured handover of clinical information. Complete this form before the resident leaves the care home and send it with them.

What is SBAR? SBAR stands for Situation, Background, Assessment, Recommendation. It is a structured communication method widely used in healthcare to ensure that critical information is communicated clearly and completely. The SBAR format helps hospital staff understand the reason for transfer, the resident's baseline, current observations, and what the care home is requesting. This form includes a dedicated SBAR section in the Clinical Information area.

Urgent Transfer: If the resident requires emergency transfer (e.g., suspected stroke, severe breathing difficulty, chest pain, or reduced consciousness), call 999 immediately. Complete as much of this form as possible before the ambulance arrives and hand it to the paramedic team. Even partial information is better than none.

Resident Information

Full Name

Date of Birth

NHS Number

Care Home Name

Address of Care Home

Transfer Details

Date and Time of Transfer

Reason for Transfer

Hospital / Department Name

Mode of Transport

Accompanying Staff Member

Clinical Information (SBAR Format)

Situation — Current Problem and Reason for Transfer

Background — Relevant Medical History and Current Care Plan

Assessment — Current Observations and Clinical Findings

Recommendation — What You Are Requesting from Hospital

Current Diagnoses

Current Medications (with doses and times)

Known Allergies

Recent Observations (BP, pulse, temp, O2 sats)

Mental Capacity Status

DNACPR / ReSPECT Status

DoLS Authorisation Status

Communication & Support Needs

Communication Needs (e.g., hearing aid, glasses, language)

Mobility and Transfer Needs

Eating and Drinking Needs (including IDDSI level)

Continence Needs

Behavioural Needs (including triggers and de-escalation)

Medication Being Sent

List All Medications Sent with Resident

Controlled Drugs Sent (quantity and signature)

Belongings Sent

List of Personal Belongings Sent

Valuables (list or confirm in safe)

Handover Confirmation

Name of Staff Member Completing Form

Role / Job Title

Date and Time of Completion

Hospital Staff Member Received By

SBAR Communication Tips

S — Situation:Briefly explain what is happening now. What is the problem? Why is the resident being transferred?
B — Background:Provide relevant medical history, current diagnoses, medications, and baseline care information that hospital staff need to know.
A — Assessment:Share your clinical findings — observations, changes in condition, and your professional opinion of the situation.
R — Recommendation:State clearly what you are asking for — admission, assessment, investigation, or treatment. Be specific.
5.Ensure all medications are sent with the resident, including controlled drugs with appropriate documentation and signatures.
6.Include a copy of the resident's care plan and any advance care planning documents (DNACPR, ReSPECT, advance decisions).

Authoritative Resources

Important Notice:This hospital transfer form provided by Care Handbook is a template for guidance only. It does not replace your organisation's approved transfer documentation or local NHS trust requirements. Always follow your employer's policies and ensure all relevant information is provided when transferring a resident to hospital. In an emergency, call 999 and provide as much information as possible to the ambulance crew.