Recommendation 4

Not enough is being done to tackle delayed discharges, which cause inefficiencies both within hospitals and more widely across the care system. Delays with discharging patients when they are medically fit for discharge reduces available bed capacity, which in turn slows admissions from A&E departments, which in turn slows the rate at which ambulances can hand over new patients, which then reduces ambulance capacity and therefore the timeliness of ambulance responses. More patients are remaining in hospital when they no longer need to do so. In Q4 of 2022– 23, there was an increase of 12% in patients remaining in hospital despite no longer needing to, compared with the same period in 2021–22. Each unnecessary delay is a bed that cannot be released for a new patient. While a proportion of delayed discharges can be attributed to problems discharging older patients from hospital into adult social care, NHS England acknowledges that the challenge does not lie entirely in social care and more work was needed in the hospital sector. Recommendation 4: As part of its Treasury Minute response, the Department should set out what it is doing to address delayed discharges caused by constraints within hospitals, problems in NHS community services, and shortfalls in social care.