Recommendation 21

We have previously noted that the fragility of the adult social care provider market was exacerbating the difficulties in discharging older patients from hospital.55 NHS England agreed that there is a clear challenge in social care. Different solutions are needed in different parts of the country, but health and social care services must work together to tackle problems with delayed discharges from hospital.56 The Department noted that social care remains primarily the responsibility of local government, but that recent changes due to the Health and Care Act 2022 had increased its oversight and awareness of the sector, and provided a better basis for shared solutions between local government and the NHS through the move from Clinical Commissioning Groups to Integrated Care Boards.57 However, NHS England acknowledged that the challenge with delayed discharges does not lie entirely in social care and more work needs to be done in the hospital sector.58