Improving hospital discharge

Once people no longer need hospital care, being at home or in a community setting (such as a care home) is the best place to continue recovery; but unnecessary delay in discharging older patients from hospital is a systemic problem with a rising trend.

For older people in particular, we know that longer stays in hospital can lead to worse health outcomes and can increase their long-term care needs. For people aged 80 years and over, 10 days spent in a hospital bed equates to 10 years of muscle wasting (NAO).

To support the reduction of delayed transfers of care (DTOC), the High Impact Change Model was developed by partners across health and social care. As outlined in the Next Steps of the Five Year Forward View, this aims to support local systems to minimise unnecessary hospital stays. The model identifies eight system changes which will have the greatest impact on reducing delayed discharge.

NHS England has produced a number of quick guides to support local health and social care systems to reduce the time people spend in hospital, when they no longer need acute care. This includes the ‘Discharge to assess quick guide’, which aims to support local health and social care systems to reduce the time people spend in hospital, at the point that they no longer need acute care. It provides practical tips and advice to commissioners and providers on discharge to assess models.

The Developing trusted assessment schemes: ‘essential elements’ guide also describes how local systems could implement trusted assessment to reduce, effectively and safely the numbers and waiting times of people awaiting discharge from hospital. Read more about how the trusted assessor scheme can reduce delays to transfers of care.