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Hospital Discharge - The Law

We are sure that you are all familiar with the terms ‘bed blocking’ and ‘delayed discharge’. These terms have been used in recent years to describe the problem of frail older people staying in hospital after they are medically ready for discharge because of the lack of appropriate support beyond the acute setting. ‘Delayed discharged’ legislation was first introduced over ten years ago to tackle the delays by setting out a coherent discharge process and imposing fines on a Local Authority for failure to act.

This has recently been updated under:

  • Section 74 and schedule 3, Care Act 2014
  • Care and Support (Discharge of Hospital Patients) Regulations 2014
     

In spite of the fines (currently £130 per day/ £155 in London), and repeated calls to action to address this issue, the delays have continued to increase, particularly during winter.  We are often approached by distressed family members who are asked to make significant decisions about future care, sometimes forgoing important health and social care assessments, in order to respond to these time delay pressures rather than focusing on care needs.


UPDATE!

The National Institute for Health and Care Excellence (NICE) has recently (December 2015) published new guidance (available at nice.org.uk/guidance/ng27) aimed at improving the hospital discharge process for adults with social care needs.

This will make interesting reading for those working in this area of care as many of the principles identified as good practice have been around for a number of years, including improving communication between professionals, discharge planning at the earliest opportunity and person centred care.  It also incorporates some key aspects of the Care Act 2014, particularly highlighting the importance of involving carers and the role of advocacy to facilitate discharge.

It may yet though become a useful tool for those seeking to ensure that patients are discharged in an appropriate and considered manner, where it states that individuals should not:

“…have to make decisions about long-term residential or nursing care whilst they are in crisis….[and]…any pressure to make beds available does not result in unplanned and uncoordinated hospital discharges” (NICE 2015, paras 1.5.11 & 1.5.12).

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