Discharging Older Patients from Hospital: an NAO report

The National Audit Office’s key findings in this report are as follows:

  • Rising demand for services, combined with restricted or reduced funding, is putting pressure on the capacity of local health and social care systems.
  • The number of recorded delayed transfers of care has increased substantially over the past two years. The official data show a 31% increase in bed days taken up by patients with a delayed transfer in acute hospitals between 2013 and 2015. The main drivers for this increase are the number of days spent waiting for a package of home care (which more than doubled between 2013 and 2015, from 89,000 to 182,000) and waiting for a nursing home placement or availability (which increased by 63%).
  • The delayed transfers of care data substantially underestimate the range of delays that patients experience. By definition, the official data only count delays that occur after clinicians and other professionals deem a patient to be ready for discharge. It does not count all patients who are no longer benefiting from acute care, or all the delays patients experience during their treatment. Based on survey results, the report estimates that the number of older patients in hospital who are no longer benefiting from acute care to be approximately 2.7 times the figure for reported delayed transfers of care. This amounts to around 2.7 million bed days a year.
  • The NHS spends around £820 million a year treating older patients who no longer need to be there.
  • Caring for older people who no longer need to be in hospital in other settings could result in additional annual costs of around £180 million for other parts of the health and social care system.
  • Health and social care providers have made limited progress in adopting recommended good practice.
  • Workforce capacity issues in health and social care organisations are making it difficult to discharge older patients from hospital effectively. Across health and social care, providers and commissioners said that staff recruitment and retention were a significant cause of delays.
  • Health and social care organisations are not sharing patient information effectively.

Full report can be found at The National Audit Office May 2016