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Short-term funding not the answer for delayed hospital discharge

A recent King’s Fund report looked at delayed hospital discharge funding, which can have a significant impact on both patients’ recovery and the efficiency and effectiveness of health and care services.

Delayed hospital discharge is a widespread and longstanding problem, yet recent government funds have come with insufficient advance notice for effective planning, according to a new report from The King’s Fund.

The report, Hospital discharge funds: experiences of winter 2022-23, looked in-depth at six health and care systems. The authors spoke to local authorities, integrated care system leads, acute trusts, Healthwatch and local care provider associations. It then collated responses to two tranches of Adult Social Care Discharge Funding in 2022/23: one of £500m from the Department of Health and one of £250m from NHS England.

The funding was allocated separately to the NHS and local authorities with an expectation that it should be pooled. However, the report found that despite system partners saying that relationships were good, they were often insufficient to develop a shared understanding of the causes of delays or to bring about meaningful, co-ordinated action to reduce delays.

One-off delayed discharge funding should be an exception

In England, it has become normal practice for government to provide additional one-off funding to reduce delays every winter, as the problem is particularly acute during the colder months.

Although local systems welcomed the extra government funding, they noted that it came at too short notice, had burdensome reporting requirements, and had to be spent over too short a period to be effective. The report recommends that short-term, one-off funding to tackle the issue of delays to hospital patient discharge should be provided only on an exceptional basis, rather than becoming an annual fixture.

The reports notes that recipients of the funding also said that some of the terms related to the funding left them feeling frustrated, as they could not be used to prevent hospital admission in the first place.

Simon Bottery, co-author of the report, said: ‘Delayed hospital discharge is a widespread and longstanding problem that affects thousands of patients, their families and loved ones. The underlying reasons for delays are often complex and vary between local systems, though workforce issues are often at the root of them.

‘Our research shows that it is essential local heath and care partners go beyond good surface relationships to develop clear, shared understandings of the causes of delays and the priorities for dealing with them. Short-term funding is not the best way to encourage this process so government should only use it in exceptional circumstances and instead focus on ensuring that systems have the underlying funding they need to develop and implement effective long-term strategies.’

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