Delayed transfers of care
A delayed transfer of care (DToC) occurs when a patient is ready for discharge from acute or non-acute care and is still occupying a bed. DToCs should be minimised through effective discharge planning and joint working between services to ensure safe, person-centred transfers.
Since April 2017, data on the number of patients delayed on the last Thursday of the month has stopped being collected. It has been replaced by a similar measure called delayed transfer of care beds, which is calculated by dividing the total number of delayed days in the month by the number of calendar days. The new measure is more representative of the entire month rather than providing a patient snapshot on one particular day.
The Community Care Act 2003 introduced responsibilities for the NHS to notify social services of a patient’s likely need for community care services on discharge, and to give 24 hours notice of actual discharge. It also requires local authorities to reimburse the NHS for each day an acute patient’s discharge is delayed where social services are solely responsible for that delay.
A delayed transfer of care from acute or non-acute care occurs when a patient is ready to depart from such care and is still occupying a bed. A patient is ready for transfer when:
a. A clinical decision has been made that the patient is ready for transfer; and
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.
There is an expectation that delays to transfers of care will be minimised through the following steps:
• Discharge planning begins on admission to hospital or in the early stages of recovery;
• There are no built-in delays in the process;
• Services will jointly review policies and protocols around discharge and have systems and processes for assessment, safe transfer and placement, as part of their capacity planning.
These steps should be guided by good professional practice and safe, person-centred transfers.
The focus of this indicator is to identify patients who are in the wrong care setting for their current level of need. Data are being collected for all adults (over 18s) in SITREPs.