Delayed transfer of care


What are delayed transfers of care

Delayed transfers of care (DToC) occur when a patient is ready to leave hospital but is still occupying a hospital bed. According to NHS England, a patient is ready to leave when

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

Delayed transfers of care are reported as the number of days where a patient delayed is occupying a bed, this may occur for many reasons. 

Why do they happen

Patients may be delayed for a variety of reasons. For example, waiting for onwards care at a community NHS facility such as a community hospital. Or waiting for social care to be arranged at a residential or nursing home or for a care package at home to be developed. Often delays can arise simply because a patient’s assessments aren’t completed before they recover. Completing a needs assessment of onward care generally requires agreement from a multidisciplinary group of hospital clinicians, social workers and other care workers.

Why do delayed transfers of care matter

Keeping patients in hospital longer than required can have long-term detrimental effects on the individual and their families, and can place additional strain on health and social care resources. 

Delayed transfers of care are costly for hospital trusts. In addition to having to pay to provide places for patients who are ready to leave, there are then insufficient beds for people who need hospital care. Delayed transfers can also be costly for local authorities. The longer an older person stays in hospital, the more dependent on longer-term social care services they are likely to be when they are discharged.

Source: Local Government Association

Further data and analysis

Delayed transfer of care - Lancashire-12 report November 2017 (PDF 849 KB)

 Page updated January 2018