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Getting Discharge Right: What you need to know

On 4 September 2024, we hosted a virtual roundtable on one of the most urgent challenges facing our health services - getting discharge right. We capture the successes, experiences and strategies shared by our panel of experts and attendees.

Getting discharge right is one of the most urgent challenges for the UK’s health and care sector. 

Currently ~15,000 beds across the UK are occupied by discharge ready patients. That’s ~15,000 people stuck in hospital, prevented from returning to their normal lives, with every day of delaying increasing their likelihood of worse health outcomes and costing the NHS thousands of pounds; and it’s also ~15,000 would-be-inpatients who have their much-needed treatments delayed, because there isn’t capacity for them. 

While the problem is substantial - it is solvable. We convened a roundtable on ‘Getting Discharge Right,’ with expert speakers (Jenny Keane, Rachel Kemp, Gareth Everton, Rachel O'Connor, Kathryn Taylor, and Mark Angus) to share the meaningful contributions that they have made, and their lessons learnt. Success stories included a 72% reduction in “no criteria to reside” patients (those who are ready for discharge), cost savings for local authorities of £3,880 per patient, and improved patient outcomes. 

Below, we capture some of the key learnings shared by our roundtable panellists and 150 participants on achieving these successes.

Getting Discharge Right: What you need to know
  1. System Leadership and Collaboration: 

Attendees emphasised the importance of joint executive leadership across health and social care. This collaborative approach was echoed throughout the discussion, highlighting the need for shared decision-making and governance, including budgetary alignment. 

  1. Data Sharing and Decision Making: 

Data sharing across health and social care interfaces remains a challenge for many systems. However, attendees shared that finding solutions was indeed possible and critical for effective planning and investment decisions. Joint demand and capacity planning across health and social care was highlighted as a key area, with participants sharing how their systems used it to drive ‘invest-to-save' transformation. 

  1. Focus on Reablement and Recovery: 

Attendees stressed the importance of shifting from passive long-term care to shorter-term recovery and care services aimed at helping people regain independence (reablement). Several examples were shared of successful increases in reablement capacity and improved outcomes for patients. 

  1. Integration of Services: 

The roundtable highlighted the benefits of integrated discharge teams and intermediate care. Experiences shared demonstrated how this approach led to more efficient discharges and better patient outcomes. 

  1. Voluntary Sector Involvement: 

Several attendees noted the crucial role of the voluntary sector in supporting discharge processes. One system's voluntary sector-led settling and call service was reported to have supported over 1,500 people to leave hospital since April. 

  1. Cultural Change: 

Overcoming risk-averse attitudes on wards, such as keeping a patient for a little longer, was identified as a key challenge. These risk-averse behaviours were flagged as potentially doing more harm than good for some patient groups, and this evidence was being used to engage professional groups in the benefits of discharge to a ‘recovery-focused’ intermediate care setting. 

 

The roundtable demonstrated that while discharge challenges are complex, they are not insurmountable. 

We'd like to thank all our speakers and attendees for their valuable contributions to this important discussion. If you would like to learn more about our discharge roundtable, discharge success stories or our service offerings, reach out to chris.bradley@thepsc.co.uk, rachel.lewis@thepsc.co.uk or joseph.norbury@thepsc.co.uk

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