Recommendation 20

NHS England told us that the reasons why patients might experience delays in leaving hospital could be divided into four categories. For one group of patients, accounting for around 20%, the delays are related directly to activity in the discharging hospital.51 NHS England told us it was largely the responsibility of the leadership within these hospitals to improve their processes, so patients are better supported to leave when they are ready.52 Between 25% and 30% of patients leaving hospital need short-term packages of care, which are a shared responsibility between the NHS and local government. A further 25% of patients need to go into NHS community settings, which is another part of the NHS.53 The smallest group, by number, are patients needing nursing or residential care, but we were told that these people can wait the longest, sometimes up to four or five weeks from when they are ready to leave hospital.54 42 Q 125 43 Q 88–90 44 Qq 46–48 45 Q 87, 89 46 Q 111 47 Qq 45, 111, AUEC0001 48 Q 63, AUEC0003, AUEC0005 49 Q 37; C&AG’s report, para 1.13 50 Qq 2, 38 51 Qq 44, 98 52 Q 99 53 Qq 102–104 54 Q 105; AUEC0006 Access to urgent and emergency care 13