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'Achieving timely 'simple' discharge from hospital', a new toolkit ...
'Achieving timely 'simple' discharge from hospital', a new toolkit

launched today by health minister Rosie Winterton, focuses on

practical steps that health and social care professionals can take to

eliminate delays in discharging patients from hospital.

Staff often have to spend too much valuable time managing mismatches

between when beds are needed for patients being admitted and when

they are made available by other patients being discharged. This is

despite the fact that at least 80% of discharges can be classified as

'simple', meaning that the patients have relatively simple ongoing

health needs that can be met without complex planning.

In some cases this can mean that patients who are well enough to go

home stay in hospital while patients who need to be admitted wait

longer than necessary in A&E for a bed to become free.

The new toolkit includes a 10 step guide to improving discharge

processes, case studies showing how real improvements have already

been delivered, and useful factsheets helping staff to identify what

action they need to take. It aims to empower all the members of the

multi-disciplinary teams involved in planning and arranging the

smooth discharge of patients from hospital by supporting them in new

ways of working.

Health minister Rosie Winterton said: 'This new toolkit is another

step on the way to transforming emergency care for patients. We know

from the Healthcare Commission's national surveys that patients

recognise delays in being allowed home as an area where standards

need improvement. We also know that smoothing the flow of patients

through the whole system is essential if we are to continue the

progress towards meeting the four-hour A&E total time target.

'I hope staff find the toolkit genuinely useful. It will help them to

deliver the key actions like treatment plans and expected dates of

discharge for all patients within 24 hours of arrival in hospital.

And the case studies clearly demonstrate the benefits of involving

the patients themselves in the discharge process.

'Patients don't want to hang around in hospital unnecessarily when

they are well enough to leave. Improving the way that discharges are

managed will have a big impact on their experience of the NHS, as

well as on the working lives of front line staff.

Director for patients and the public, Harry Cayton, said: 'No-one

wants to spend more time in hospital than they have to. But leaving

hospital if you have been seriously ill or are frail can be a

worrying time. Making the right arrangements with social care and

with friends and family is essential. I hope this guide will help the

NHS to get it right for everyone.'


1. The 'Achieving timely 'simple' discharge from hospital' toolkit is

available here.

2. The NHS Plan target for total time in A&E is that by the end of

2004 all A&E patients should be discharged, admitted or transferred

within four hours of arrival. To allow for clinical exceptions to the

target (i.e. patients who for clinical reasons need to remain in A&E

longer than four hours) trusts will be expected to reach an

operational standard against the target of 98%. Current performance

is approximately 95%.

3. 'Timely' discharge is when the patient is discharged home or

transferred to an appropriate level of care as soon as they are

clinically stable and fit for discharge.

4. 'Simple' discharge patients will normally go to their own home and

can be discharged directly from A&E, ward areas or assessment units.

'Complex' discharge will often be to a carer's home, intermediate

care or a care home; these patients' lengths of stay are harder to

predict and they will have complex ongoing health and social care


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