Local heath 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 report, Hospital discharge funds: experiences of winter 2022-23, looked in-depth at six health and care systems. The authors spoke to local authorities, integrated care system leads, acute trusts, Healthwatch and local care provider associations.
Despite system partners saying that relationships were good, the report finds they were often insufficient to develop a shared understanding of the causes of delays or to bring about meaningful, co-ordinated action to reduce delays.
The report looks at systems’ responses 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.
Although local systems welcomed the extra government funding, they noted that 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 hospital patient discharge should be provided only on an exceptional basis, rather than becoming an annual fixture.
The reports notes that recipients of the funding also said that some of the terms related to the funding left them feeling frustrated, as they could not be used to prevent hospital admission in the first place.
Simon Bottery, co-author of the report, said: ‘Delayed hospital discharge is a widespread and longstanding problem that 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 heath 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 process so government should only use it in exceptional circumstances and instead focus on ensuring that systems have the underlying funding they need to develop and implement effective long-term strategies.’
In response to the report, Professor Martin Green OBE, Chief Executive of Care England said: “Delayed discharges from hospital remain one of the biggest problems facing our country. This problem is not new. There has been little improvement over the last decade in overcoming this issue. The adult social care sector has called for long-term, transparent funding, joint strategy planning and shared learning time and time again. It is incumbent not just on systems to build strong relationships across health and care, but also on central government to provide a funding strategy to allow for long-term planning and facilitate the strengthening of partnerships locally and nationally.”