Policies for reducing delayed discharge from hospital.

INTRODUCTION: Delayed discharge from acute hospital has been a cause of concern for the last 10 years. Older people with complex health needs are particularly vulnerable to delayed discharge with negative consequences for their health and wellbeing. SOURCE OF DATA: Review of the literature on the impact of the Community Care (Delayed Discharge) Act (2003) and subsequent policy initiatives on delayed discharges. Areas of agreement A number of cross-institutional complexities contribute to delayed discharges. Policy measures have contributed positively to reducing delayed discharges. Investment in intermediate care services has provided a range of services to promote maximum independence for older people after acute hospital admission. Joint working between health and social services is necessary to prevent delayed discharges. AREAS OF CONTROVERSY: Pressure to achieve rapid hospital throughput may be contributing to older people leaving hospital too soon and to recent increases in hospital re-admission rates. Policy measures are extending to older people with mental health problems. AREAS TIMELY FOR DEVELOPING RESEARCH: Patient and carer experiences of delayed or premature discharge. Quality and equity of access to intermediate care for older people.