High impact change model

Supporting local care and health systems to manage patient flow and discharge


This is the webpage for the original High Impact Change Model used for the Better Care Fund 2019/20 national requirements. The High Impact Change Model has undergone a refresh in 2019.

The high impact change model offers a practical approach to manage transfers of care. It can be used to self-assess how local care and health systems are working now, and to reflect on, and plan for, action they can take to reduce delays throughout the year.

The model identifies eight system changes which will have the greatest impact on reducing delayed discharge:

  • early discharge planning
  • systems to monitor patient flow
  • multi-disciplinary/multi-agency discharge teams, including the voluntary and community sector
  • home first/discharge to assess
  • seven-day services
  • trusted assessors
  • focus on choice
  • enhancing health in care homes.

The High Impact Change Model includes an editable action plan and can be used to support collaborative conversations across local systems. It is recognised by the sector as a valuable resource / practical self-assessment tool to enable care and health systems to examine current practices and look at where and how improvements can be made to manage transfers of care. It is included in the BCF national conditions for 2017/18.

This infographic shows links between the high impact change model and other key sector-led improvement tools and offers.