Local health and care systems lack a shared understanding of the causes of hospital discharge delays in their area and of the best ways of tackling them, says a report from The King’s Fund.
The researchers found that short-term pots of government funding, aimed at reducing the number of people experiencing a delay to their hospital discharge, did not make it easy for local services and providers to develop the shared data and metrics needed to fully understand and tackle the root causes of delays and how to reduce then.
Hospital discharge funds: Experiences of winter 2022-23 looked at how local systems’ responded to two tranches of Adult Social Care Discharge Funding in 2022/23, one of £500m from the Department of Health and one of £250m from NHS England which were made available in September 2002 and January 2023 respectively.
Researchers looked in-depth at six health and care systems across England by speaking to local authorities, integrated care system leads, acute Trusts, Healthwatch and local care provider associations.
Researchers found that despite system partners saying that relationships were good, information was not always shared or there was a lack of agreement on which performance and discharge metrics should be used, in order to develop a better understanding of the causes of delays and how to reduce them.
The researchers found that local systems welcomed the extra government funding but said it came at too short notice, had burdensome reporting requirements and had to be spent over too short a period to be effective. The report recommends that short-term, one-off funding to tackle the issue of delays to patients being discharged from hospital should be provided only on an exceptional basis rather than becoming an annual fixture.
However, recipients of the funding also said that some of the terms related to the funding left them feeling frustrated as the money had to be spent on discharge and could not be used to prevent hospital admission in the first place.
Simon Bottery, a Senior Fellow at The King’s Fund and co-author of the report said: "Delayed hospital discharge is a widespread and longstanding problem which affects thousands of patients, their families and loved ones. The underlying reasons for delays are often complex and vary between local systems, though workforce issues are often at the root of them.
"Our research shows that it is essential local health and care partners go beyond good surface relationships to develop clear, shared understandings of the causes of delays and the priorities for dealing with them. Short-term funding is not the best way to encourage this so government should only use it under exceptional circumstances and instead focus on ensuring that systems have the underlying funding they need to develop and implement long-term strategies."
As well as making recommendations on the conditions and nature of government funding, the report makes a number of key proposals on planning, integration and monitoring such as suggesting places should further develop and share data on hospital discharge, so that there is a genuinely shared view of performance and areas for improvement.
