Delayed Discharge

Reliably achieving safe, timely and person centred discharge from hospital to home is an important indicator of quality and a measure of effective and integrated care. Improving the pathway from hospital to home is at the heart of the 2020 Vision. Every unnecessary day in hospital increases the risk of harm for the individual, drives up the demand for institutional care and reduces the level of investment that is available for community support.

In 2010, the Report of the Delayed Discharge Expert Group recommended that discharge home from hospital should routinely take place in days not weeks.

When a patient no longer requires to remain in an acute hospital, they should be discharged home and their post hospital rehabilitation, care and support needs met by the community health and care team. If return home is not possible in the short term, they should transfer to a step down bed in the community for a period of Intermediate care and rehabilitation.

 Supporting Improvement

The JIT offers practical support to help partnerships improve discharge pathways, deliver better outcomes for people and reduce the bed days associated with delays.

Our Home First resource has links to good practice guidance and actions that improve care outcomes across the whole pathway from home to hospital and back.

These include

  • A Self Assessment Tool to help develop an action plan to tackle delays
  • Pathway Review tool to consider missed opportunities for earlier action
  • Sample admission, transfer and discharge protocols
  • Good Practice Guide for discharging people who lack capacity.
  • CEL 32 (2013) and a teaching slide set on implementing the updated guidance on choosing a care home on discharge from hospital
  • Equipment good practice guide and self-evaluation tool
  • Adaptations good practice guide and self-evaluation tool
  • Information about Integrated Discharge Hubs

In August 2014, JIT established and leads a cross sector Discharge Task Force.

The remit of the group is to:

  • Agree short / medium term priorities for support to improve discharge
  • Advise on use of national funding to improve performance
  • Commission and review the impact of tests of change of innovation projects
  • Monitor performance against current delayed discharge and bed days targets
  • Consider future targets in the context of the Residential Care Task Force report and the national health and wellbeing outcomes

JITs Intermediate Care Community of Practice website has digital stories, case studies, protocols and service evaluations on improving transitions of care.

For further information about JIT support for Delayed Discharge contact Dr Anne Hendry