Home from hospital: How housing services are relieving pressure on the NHS

This report sets out the impact of delayed transfers of care, the implications for the NHS and the solutions that are offered by housing providers, including the cost benefits these solutions provide to the NHS.


Delayed transfers of care, often referred to as ‘bed-blocking’, occur when a person is assessed as ready to leave hospital and is still occupying a hospital bed. According to NHS England1, a patient is ready to depart when:

a) A clinical decision has been made that the patient is ready for transfer
b) A multi-disciplinary team decision has been made that the patient is ready for transfer, and
c) The patient is safe to discharge/transfer.

The main groups affected by delayed transfers of care are older people, people with mental health problems and people experiencing homelessness. The number of recorded delayed transfers of care has increased substantially over the past few years. According to National Audit Office official data2, between 2013 and 2015 there was a 31% increase in bed days taken up by delayed transfer patients in acute hospitals.

Delayed transfers of care are costly for the NHS. The National Audit Office3 (NAO) estimates that the NHS spends around £820m a year treating older patients who no longer need to be there. The NAO notes that “Without radical action to improve local practice and remove national barriers, this problem will get worse and add further strain to the financial sustainability of the NHS.”

Housing providers are ideally placed to relieve pressure on the NHS, and have developed a joined up plan to extend and increase the services they offer to help people out of hospital, into a suitable home with the right support.

There are four key components to this sector-wide offer:

1. An increase in the number of housing step down units or beds nationally which can facilitate efficient discharge from hospital.
2. More housing staff seconded to discharge teams locally to coordinate and speed up transfers of care.
3. Care packages to help prevent people from needing to go into hospital in the first place and to reduce readmissions.
4. A commitment to facilitating robust evaluation of this solution.

This offer will ensure that people are getting the care and support they need, and will free up the NHS to deliver its services to those who need them most.

Published : 8th September 2017*

Author : Ian Copeman, Margaret Edwards and Jeremy Porteus  [ More From This Author ]

Publisher : National Housing Federation  [ More From This Publisher ]

Rights : National Housing Federation

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* Although BASW has prepared the information contained within Social Work Knowledge with all due care and updates the information regularly, BASW does not warrant or represent that the information is free from errors or omission. Whilst the information is considered to be true and correct at the date of publication, changes in circumstances after the time of publication may impact on the accuracy of the information. The information may change without notice and BASW is not in any way liable for the accuracy of any information printed and stored or in any way interpreted and used by a user.