Key Takeaways
- Care recipients who are medically fit to be discharged but remain in the hospital are at a higher risk of developing further hospital-acquired infections and losing mobility and independence.
- Delays in discharge also impact hospital bed availability, which leads to delays in ambulance handover and the admission of more people who require care from the A&E.
- The factors contributing to discharge delays include medical complications, post-discharge care, housing and accommodation needs, and delayed patients assessments.
- Delayed discharge puts pressure on healthcare budgets and increases hospital costs.
The Causes Behind Delayed Hospital Discharges in the UK
Among care recipients in the UK who have been in hospital for at least 14 days since their arrival, about 1000 people per day were unable to be discharged due to a lack of nursing or residential homes as a permanent placement option, while 1700 were waiting for a rehabilitation bed in other settings.
About 2000 people a day wait for discharge assessment resources and begin care at home, the highest number among all categories. Some delays involve hospital complications, like waiting for a final medical decision or discharge summary. Other examples include waits for community adaptations and equipment, transportation challenges and medicines to take home. These complex challenges put considerable pressure on the NHS. More extensive collaboration among colleagues and local authorities is required so that more people can get home when they are medically fit to leave. The reasons people cannot leave hospital when they are medically fit to do so are often complex, but we all need to do more to find the solutions to this challenge.
Social Care Provision
Social care provision usually covers a more extensive range of support for people of all ages and their carers. This support can be provided by the local council, charities, private care providers, or informally by family members.
Local authorities have the most significant responsibility for children’s social care as they play the most crucial formal role in assessing the needs for finding proper care. The differences in budgets, costs, and discretion in choosing the best care for individuals outside the hospital contribute to a delayed hospital discharge process. In contrast, the social care system still focuses on a longstanding call for reform. The lack of sufficient social care capacity also means that people waiting for social care support to become available and be discharged are another contributing factor to prolonged hospital stays.
Capacity Issues
People who remain in the hospital for three weeks or longer often face adverse health outcomes and are more vulnerable to infection, mobility loss and a reduced degree of independence. Although longer stays in the hospital may sometimes be necessary, people who remain due to a delayed discharge outline critical points for improving the quality of care provided.
One such improvement can be made regarding the capacity of beds and accommodation spaces, which is closely correlated with the shortage of social care resources. Discharging patients often require ongoing rehabilitation and care upon discharge, but there is still a lack of available community-based options, which leads to delays. The limited capacity of nursing homes and other facilities only contributes to this challenge, and without sufficient places for people to go to when they are discharged, hospitals face the pressure to retain patients for longer. With the diluted integration between health and social care services, better communication and coordination between hospitals and care providers is crucial.
Delayed Assessments
Proper assessment is essential for determining the continued course of treatment and developing an appropriate care plan. When assessment is delayed, it prolongs the time required for healthcare professionals and mental health professionals to continue with the recovery plan after discharge. In some cases, assessing people’s conditions involves speaking to specialists and other healthcare providers, which is a lengthy process that can prolong the assessment further.
Hospitals need more resources, and delayed patient assessments often lead to further inefficiencies in resource allocation. Beds are occupied by people waiting and who could be discharged if the evaluation was conducted on time. Without proper and timely assessment, the individual’s condition could deteriorate and prolong the hospital stay. Additionally, it impacts the number of patients admitted from A&E and ambulance handover. Care and Healthcare providers must make thorough assessments by streamlining processes and improving communication among healthcare teams.
Financial Constraints
In the UK, home or social care services are often required for continuous care and ongoing support after leaving the hospital. However, the funding constraints for social care services can be limited, leading to further delays in arranging proper care for patients before discharge. With adequate funding, patients can access additional resources while remaining in the hospital.
The entire health and social care system faces budgetary constraints that impact the availability of services and resources. In contrast, hospitals face pressure to discharge care recipients and manage the occupancy of beds and costs. This pressure results in delayed discharge and receiving post-discharge support. Proper community support services and rehabilitation programs are vital in supporting patients discharged and transitioning from hospital to home or other settings. However, funding shortages still limit the availability of these services, causing delays.
Patient and Family Preferences
A number of patients prefer being discharged and receiving care in a different setting, whether returning home or going to a rehabilitation facility, nursing or care home. If the preferred option is unavailable due to resource constraints or other challenges, discharge may be delayed until further arrangements are made. Many care recipients prefer to recover in their homes with their families, but arranging the needed supporting services and equipment takes time and more resources.
Delays often occur when these services aren’t ready on time or when logistics are challenged. Caregiver availability can vary, which is why more arrangements need to be made to ensure accessibility. Also, delays can occur when caregivers need to make further arrangements regarding ongoing post-discharge treatment and when discrepancies occur between patients’ preferences and the treatment plan. People’s needs should always remain at the forefront of care.
Integration of Health and Social Care
Historically, the UK’s health and social care system worked as two separate entities that received funding from different sources. However, the lack of integration between these systems led to inefficiencies that we still witness today, including delays in care coordination. Communication and integration between these sectors are necessary for the timely exchange of information that contributes to delayed discharges and difficulties in arranging proper care after discharge.
Health and social care providers often have different values and priorities, creating collaborative work challenges. The differences in organisational structure and accountability can hinder the integration of services and lead to hospital discharge delays. Addressing these challenges requires more efforts to improve coordination and collaboration. Working together to create a streamlined process can align the incentives and improve communication while reducing delays and improving patient outcomes.
Unique Community Services Dedicated to Reduce Delayed Hospital Discharges
As a brand under the Catalyst Care Group, Unique Community Services is a complex care provider and transforming care advocate, preventing unnecessary hospital admission and delayed hospital discharge.
Utilising Positive Behaviour Practices (PBS) and understanding the pain points of the local authorities and the challenges the health and social care system faces, we promote the well-being of the individuals we serve. We do this by supporting local care in the comfort of people’s homes. Getting care at home should be the first option to alleviate the system’s pressure by focusing on providing bespoke health services and improving community health.
If you need additional assistance and support, contact one of our offices in Manchester, Leeds or Bristol to see how we positively impact people’s lives.
