Delayed discharges and hospital type Evidence from the English NHS

Monograph

Delayed discharges of patients from hospital, commonly known as bed-blocking, is a long standingpolicy concern. Delays can increase the overall cost of treatment and may worsen patientoutcomes. We investigate how delayed discharges vary by hospital type (Acute, Specialist, MentalHealth, Teaching), and the extent to which such differences can be explained by demography, casemix,the availability of long-term care and hospital governance as reflected in whether the hospitalhas Foundation Trust status, which gives greater financial autonomy and flexibility in staffing andpay. We use a new panel database of delays in all English NHS hospital Trusts from 2011/12 to2013/14. Employing count data models, we find that a greater local supply of long-term care (carehome beds) is associated with fewer delays. Hospitals which are Foundation Trusts have fewerdelayed discharges and might therefore be used as exemplars of good practice in managing delays.Mental Health Trusts have more delayed discharges than Acute Trusts but a smaller proportion ofthem are attributed to the NHS, possibly indicating a relatively greater lack of adequate communitycare for mental health patients.