Despite the best efforts of trust leaders and their system partners, discharging medically fit patients from hospitals in a timely way remains an ongoing challenge for the health and care system. While the number of patients who remain in hospital longer than required is now falling, the latest figures for May 2023 show that, on average, 12,300 people a day are residing in hospital despite being medically fit for discharge.

The factors contributing to delayed discharges are complex, and long-term solutions will require greater collaboration and a shift in the way that services are delivered. In addition to improvements to policies and procedures within a hospital setting, lasting change must be underpinned by greater government investment in, and prioritisation of, preventative approaches to keep people well, as well as in community health services and social care.

National stakeholders, including NHS England, also play a key role in supporting trusts, and their partners, to address local challenges around delayed discharges. The discharge frontrunner scheme is an example of how national support can empower leaders to innovate and test interventions targeted to local challenges and needs.

Over recent months, we have spoken to programme leads from four discharge frontrunner sites (Leeds Health and Care Partnership, Four Localities Partnership, Coventry and Warwickshire Integrated Care Board, and Sussex Health and Care Integrated Care System) to better understand their work during the first six months of the scheme. There are important learnings from these frontrunners, including on the importance of building trusted relationships and a shared vision between system partners, and developing data collection and sharing to create a 'single version of the truth' across a system.

As we move towards winter 2023/24, we hope that these case studies will offer some valuable learnings for your system, and support work that may already be underway in your area.