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Decisions relating to the preparation for hospital discharge of medical patients can take place at any time after admission to hospital. Referrals to the hospital departments of social work, occupational therapy and physiotherapy, and to community nursing, health visiting and social services are a key factor in this preparation. The referral process is complex and multifaceted and can be analyzed in terms of the questions of who initiates the referral, for what reasons, and at what point in the patient's career. The variant views of role of those professionals involved in the referral process and their perceptions of the situation affect what subsequently takes place and can be examined in relation to each other and to the referral process itself The complexity may be increased further by the intervention of a patient's relatives

Referrals are made on the basis of a social diagnosis, the sources of information for which are diverse, with the result that the referral process is unstandardized and unpredictable.