Intended for healthcare professionals

Feature Data Briefing

I’m a healthy patient; get me out of here

BMJ 2016; 353 doi: (Published 29 June 2016) Cite this as: BMJ 2016;353:i3585
  1. John Appleby, chief economist
  1. King’s Fund, London, UK
  1. j.appleby{at}

Delays in discharging patients can’t be blamed solely on social care, finds John Appleby

Ask hospital finance directors what concerns them most at the moment and two issues are increasingly top of their list: problems with getting patients into hospital and problems getting them out.1 The two are not, of course, unconnected. In fact, the measure of problems of getting out of hospital—delayed transfers of care—connects with the whole process of hospital and out-of-hospital care, from the use of beds and clinical decisions to treat, to the flows (and blockages) in emergency departments. Apart from the costs of delays to patients in emotional and health terms, the cost to the NHS has been estimated at £900m (€1000m; $1200m) a year.2 Other estimates put it at around £540m a year.3

The numbers of patients in a hospital bed but ready to be discharged fell between 2007 and 2010, and then stayed relatively …

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