What are the recommended follow-up protocols for patients discharged after a head injury assessment in primary care?

Patients discharged after a head injury assessment in primary care should receive verbal and printed discharge advice that is age-appropriate and includes details about the injury, risk factors for returning to emergency care, the recovery process, and contact information for community and hospital services in case of delayed complications. A responsible adult should stay with the patient for the first 24 hours after the injury to monitor for any deterioration. Patients and their carers should be informed about the possibility of persistent or delayed symptoms and advised on when to seek medical review. If the patient presented with drug or alcohol intoxication, offer advice on misuse when fit for discharge. Follow-up should include consideration of referral to investigate causes of the injury (e.g., falls assessment or safeguarding services) and referral to specialists trained in managing traumatic brain injury if symptoms persist. For patients attending emergency departments, a discharge letter should be sent to their GP within 48 hours, including clinical details and shared with relevant community health professionals. Patients should be advised to gradually return to normal activities with a regular schedule of activity and sleep, and be assessed for anxiety, depression, or post-traumatic stress disorder if symptoms persist beyond three months. Referral to multidisciplinary neuropsychological rehabilitation or specialist services may be appropriate for ongoing cognitive, emotional, or behavioural difficulties. Supervision arrangements at home must be ensured before discharge, especially for those with pre-existing cognitive impairment or returning to custodial settings. Regular follow-up and reassessment should be tailored to the individual's rehabilitation needs, with updates to the rehabilitation plan every 4-6 weeks if applicable.