We know that long stays in hospital are not good for patients or their independence and can lead to poorer health and economic outcomes.

Both delays in discharge processes and shortages of capacity in social care and community care are making it more challenging to discharge patients from hospitals and mental health services.

To improve this there must be an increase in capacity in step-down services (‘intermediate care’) and social care, especially domiciliary care, which is why the government is investing up to £7.5 billion over the next two years, on top of previously committed funding to reform the adult social care system.

Improve joint discharge process

Improved processes also play a critical role in improving discharge: this means processes within hospitals and between hospitals, community services, local authorities and social care.

Discharge planning should begin when patients are admitted to hospital to ensure that people can get home or to a more appropriate setting as soon as possible, with services in place if needed.

We will work with local government and the social care sector to ensure an integrated approach to building capacity, so that patients have rapid and reliable access to the joined-up health and care services they need when leaving hospital.

Scale up intermediate care

A programme of work is underway to develop and pilot a new approach to intermediate care, working with local authorities and voluntary and community partners. This expansion of ‘step-down’ care is designed to help people move from hospital into more appropriate settings for their needs, with the right wrap-around support for their rehab and reablement.

By autumn 2023, NHS England will also develop a new planning framework and national standard for rapid discharge into intermediate care, building on the learning from the frontrunner sites. As part of this framework, NHS England will develop a national data collection to track delivery, alongside a minimum dataset for intermediate care and regional action plans to improve data quality.

Guidance and resources

• Intermediate care framework for rehabilitation, reablement and recovery following hospital discharge: Building on the work of discharge frontrunners this best practice guidance focusses on a number of recommended actions that systems should consider in partnership with their intermediate care services.
• A community rehabilitation and reablement model: This new community rehabilitation and reablement model, published alongside the intermediate care framework, aims to ensure that the individual (and their families) is at the centre of discussions and that any transition points will be as seamless as possible.

Scale up social care

Alongside these improvements to discharge processes and intermediate care, local government, the NHS and the social care sector will work together to improve access to social care, with a particular focus on domiciliary care, supported by the Better Care Fund, additional social care funding and the government’s reforms to adult social care.

Over the last year the government made available up to £2.8 billion in 2023/24 and £4.7 billion in 2024/25 of additional funding to put the adult social care system on a stronger financial footing. This will support an increase in capacity and improve the quality of and access to care for many of the most vulnerable in society.