Hospital discharge and its impact on patient flow through hospitals (Wales) - consultation response

In January 2022 we responded to the Health & Social Care Committee’s consultation on hospital discharge and its impact on patient flow through hospitals. We welcomed this consultation as this will ensure that action will be taken to address plans to explore how patient flow through hospitals can be improved.

The purpose of this consultation was for Health & Social Care Committee to identify:

  • the scale of the current situation with delayed transfers of care from hospital
  • the impact of delays in hospital discharge, both on the individual and the patient flow through hospitals and service pressures
  • the variations in hospital discharge practices throughout Wales and cross-border, and how they are meeting the care and support needs of individuals
  • the main pressure points and barriers to discharging hospital patients with care and support needs, including social care services capacity
  • the support, help and advice that is in place for family and unpaid carers during the process
  • what has worked in Wales, and other parts of the UK, in supporting hospital discharge and improved patient flow, and identifying the common features
  • what is needed to enable people to return home at the right time, with the right care and support in place, including access to reablement services and consideration of housing needs.

Our response and recommendations

We drew upon evidence from members' clinical experience.

  • There are different experiences in various settings. For an accurate assessment of the scale of the current situation with delayed transfers of care from hospitals across different parts of Wales, we suggested requesting this data from Health Boards.
  • The key changes needed from a paediatric perspective are around delivering care and services closer to home in the community. These include foster services, CAMHS and pain management services as referenced previously. Delivering these services will require proper resourcing and developing the necessary workforce.
  • In addition to reducing waiting time for discharge, delivering effective community-based services could prevent hospital admissions in the first instance. This is acknowledged in – and is the direction of travel set out in - A Healthier Wales, the Welsh Government’s long term plan for health and social care. We welcomed this plan when it was published, particularly in terms of its focus on delivering care in community settings close to people’s homes; and on intervening early to prevent hospital admissions in the first place.
  • We believe the focus should be on delivering these commitments by improving child health through early intervention and prevention; and resourcing services to deliver services in the right settings.