Enhanced offer of support

The enhanced offer of support seeks to help those systems which are most challenged in improving patient flow and reducing delayed transfers of care.


Why not home? Why not today?

‘Why Not Home? Why not today?’ describes practical, collaborative approaches to tackle the complex and long-term challenges of delayed transfers from hospital settings keeping the patient as the focus.

The report will be of interest for health and social care, commissioners and providers. It explores the behaviours, findings and key causes identified in the analysis of three areas – Sheffield, North Cumbria and Fylde Coast. It offers tangible suggestions for how others might use this experience to tackle delays in their own health and social care systems.

An example of the results from one of the participating locations included:

  • achieving national DTOC targets for the first time
  • saving nearly 20,000 bed nights through improved flow
  • decreasing lost bed days by 35 per cent in 12-weeks
  • decreasing lost bed days by 32 per cent in the two-weeks following the Christmas period.
  • avoiding £1 million of in-year costs.

Enhanced programme

The Department of Health and Social Care, NHS England, NHS Improvement, the Local Government Association, ADASS and The Better Care Support Team have teamed up to help local systems get to the root of why delayed transfers of care remain a significant challenge up and down the country. The national partners have created a pooled fund to undertake 14 whole system reviews to improving patient flow and reducing delayed transfers of care.

The approach involves engaging with local health and care systems with a view to identifying the nature and scale of the short, medium and longer term challenges, and the identification of corresponding improvements ranging from quick wins to more substantial improvements.

The expected benefits of the project include:

  1. improved outcomes for people who have been discharged from hospital as well as stabilise or decrease emergency readmissions
  2. reductions in numbers of delayed discharges
  3. clear processes and pathways which are understood by people who use services as well as staff and stakeholders
  4. firm collective grip on data which informs and drives continuous improvement
  5. practical actions/recommendations that the system can own and deliver
  6. whole system engagement and alignment which encourages collaboration and a ‘no blame’ culture
  7. engagement of front line staff and leaders in assessing the problem and designing the solution. 
The joint support offer for managing transfers of care is a partnership made up of the Association of Directors of Adult Social Services (ADASS) , the Better Care Support Team, the Department of Health and Social Care, the LGA, NHS England and NHS Improvement.

If you require support, please contact CHIP@local.gov.uk