Trust leaders are today calling for an emergency approach between the NHS, local and national government and the care sector to take immediate action to enable patients who no longer require complex medical care to be rapidly discharged from hospitals into alternative, appropriate settings.

In the face of unprecedented operational pressures on health and care services, and rising COVID-19 hospital admissions, trust leaders have highlighted cases of patients stuck in hospital who could be safely discharged if they were given appropriate care and support. 

Trust leaders report that, in parts of London, the South East and the East of England NHS where hospitals, community services and community support at home services are full, there is spare capacity in the care sector and immediate co-ordinated action to access that capacity is now becoming urgent.

Enabling patients to leave hospital when they are well enough would help unblock capacity bottlenecks currently facing the sector and allow sicker patients, many with COVID-19, to be admitted and treated.

Patients who no longer require complex medical care could be discharged into a range of settings, including:

• Their own home if there was sufficient community and/or social care capacity to support them;
• Residential and nursing home settings if they are provided with an intermediate care package; and
• being discharged to, or returning to, a care or nursing home.

Chris Hopson, chief executive of NHS Providers said:

"Pressures on the NHS have reached a point where we need to urgently identify additional capacity – beyond hospitals and NHS community service beds - to ensure newly arriving patients get the care they need.

"We know that in some places acute hospitals, and NHS community services are now reaching full capacity, including surge capacity.

"We need more beds, and with the right NHS clinical support and government financial support, there is a potential opportunity to use care and nursing homes and extra social care at home for that additional bed capacity.

"There is, of course, no question of using this capacity for patients who could introduce COVID-19 infection risk into care homes or for patients requiring complex or specialist hospital care. 

We understand from trust leaders that, in some areas, there is extra available capacity in the care sector that could be accessed.

"But we understand from trust leaders that, in some areas, there is extra available capacity in the care sector that could be accessed if the NHS, local and national government and the care sector acted at pace as though we are in an emergency situation. This is where trust leaders in London, the South East and the East of England now feel they are. But they recognise the NHS, clinically, and the government, financially, need to support the care sector.

"The government needs to provide extra financial incentives and support for the care sector to open up any spare capacity they have on the basis that this is now becoming an emergency. This could also mean additional funding for domiciliary care which social care colleagues tell us is key. The NHS needs to consistently provide clinical and therapy support where needed, for example by treating any beds with higher acuity discharged hospital patients as extended community beds.

"This will require rapid, effective, working at local level, supported nationally, but unless we act in the next few days, we will have missed what many trust leaders feel is a vital opportunity to maximise outcomes for the greatest number of people."