After hospital discharge, the important task is to establish one accurate, current medicine list and a clear monitoring plan. A home review can bring the discharge letter, previous prescriptions and the medicines actually being taken together. It should clarify changes rather than automatically restart every old prescription.
Prepared by The Wellness Team. Evidence checked 2 November 2026.
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What is medicines reconciliation?
It is the process of comparing an accurate list of medicines with the list currently in use, identifying differences and resolving them. NICE recommends medicines reconciliation in primary care after discharge as soon as practically possible, before a prescription or new supply is issued and within one week of the practice receiving the information.
That recommendation is not a reason to wait a week if a dose is unclear today. Contact the discharging team, usual GP or pharmacist promptly when instructions conflict or an essential medicine is missing. Do not guess between two lists.
What belongs on the table for a home review?
Gather the discharge summary, medicines supplied by the hospital, the previous repeat list, blister packs and all over-the-counter products. Include inhalers, creams, eye drops, injections and supplements. Keep labels visible and note what was actually taken, including missed doses and products stopped by the patient.
For medicines taken weekly or less often, the last dose date can be important. Include known allergies and the nature of previous reactions. A photograph of a box can help identify it, but the prescriber may still need the original instructions and clinical record.
Which questions should each change answer?
For each medicine started, stopped or changed, ask why the change was made, which dose is current, how long it is intended to continue and whether monitoring is needed. Ask whether an old repeat prescription should remain inactive. A temporary hospital medicine should not become permanent simply because it appears on a list.
Make sure the plan covers both treatment and practical supply: who will issue the next prescription, which pharmacy is being used and what happens before it runs out. A review that produces a list but leaves those decisions unresolved is not yet a workable plan.
Discuss your priorities and the appropriate appointment. The team will confirm suitability, availability and the complete fee before booking.
Why might the home setting help?
The clinician can see how medicines are stored, whether duplicate boxes are in use and whether the person can open packaging or follow the schedule. With permission, a carer can explain what happens between formal appointments. These practical details may explain a problem that does not appear in the discharge letter.
Do not throw away every old medicine before a professional has clarified the list. Keep uncertain products separate and seek advice. Ask the pharmacist about safe disposal once the plan is confirmed, rather than keeping stopped medicines mixed with the current supply.
When is a review urgent?
Seek urgent advice for a potentially harmful dosing mistake, a missing essential medicine or concerning new symptoms. Call 999 for a medical emergency such as severe breathing difficulty, collapse, stroke symptoms or a severe allergic reaction. A routine home visit should not delay emergency treatment.
Do not assume a new symptom is merely a side effect, and do not stop an important prescribed treatment without advice. If the hospital instructions are unclear, the team that made the change may be best placed to clarify it while the community clinician coordinates the ongoing plan.
How should follow-up be documented?
Ask for one dated list showing the agreed medicines and a separate plan for tests, dose review and prescription responsibility. Share it with the usual GP, pharmacy and relevant carers through the appropriate route and with consent. Check that changes reach the repeat prescribing record; a private assessment alone does not prove that record has been updated.
A premium home assessment should reduce the work the patient and family must carry. Clear handover, practical instructions and a named route for questions matter more than a long list of recommendations without an owner.
What should a premium home assessment include?
A well-organised visit brings clinical time, a proper examination, careful review of the available records and a clear plan together in the place where care is needed. Ask how findings will be documented, who will organise agreed tests or referrals and how questions after the visit will be handled. Where family members are involved, agree what may be shared with the patient's permission. Convenience has most value when the next step is clear.
For published London market context, consultant geriatrician Dr Pandora Wright lists a home Comprehensive Geriatric Assessment at £685. That is a specialist service with its own scope, not a like-for-like GP visit or a Wellness tariff. It illustrates why professional role, preparation, reporting and follow-up belong alongside the headline fee. The Wellness team confirms an individual quote for the service it can arrange, including any separately agreed investigations or follow-up. A GP assessment does not imply that a consultant geriatrician is attending.
How do I arrange the right visit in London?
Send the team the postcode, the person's age, a brief description of the concern and the timing you are hoping for. Explain any stairs, access needs or communication support. Do not send a complete medical record through an informal enquiry; ask for the appropriate secure route. The team needs to confirm the suitable clinician, location, timing and full fee, rather than treating an enquiry as a confirmed attendance.
Enquire about a personalised doctor home assessment. You can also call 020 3951 3429.
Sources and evidence limits
- NICE NG5: medicines optimisation, reconciliation and structured review
- Published London specialist home-assessment scope and fees
This is general information, not a diagnosis, prescription or individual clearance for a procedure. Sources inform the discussion but do not imply endorsement of this clinic. Appointments, investigations and fees must be confirmed for the individual enquiry.