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Ensure hospitals can discharge emergency admissions at a similar rate at weekends as on weekdays

Last updated: 09:41am 17 May 2019

We will also ensure hospitals can discharge emergency admissions at a similar rate at weekends as on weekdays, so that when someone is medically fit to leave hospital they can, whichever day of the week it is.

Conservative Party Manifesto 2017, p.69

Our verdict

A body of research gathered together by the government in 2015 pointed to what is known as “the weekend effect”, meaning “an association between weekend hospital admissions and poorer patient outcomes”. Included in that research was a report by the Academy of Medical Royal Colleges which found that:

“the patient’s care pathway is often put into hibernation particularly over weekends, resulting in delays in…discharge from hospital.”

When a patient remains in hospital longer than necessary it is known as a “delayed transfer of care” (DTOC). This policy is essentially a promise to bring the weekend DTOC rate for emergency admission into line with weekdays.

The most significant action under this government has been the publication of the NHS Long Term Plan. The plan outlines several initiatives to tackle DTOCs:

  • same day emergency care
  • shared savings scheme
  • digitisation and integration of community services
  • placing therapy and social work teams at the beginning of the acute hospital pathway
  • an expectation that patients will have an agreed clinical care plan within 14 hours of admission which includes an expected date of discharge
  • implementation of the SAFER patient flow bundle and multidisciplinary team reviews on all hospital wards every morning
  • a ’12-point discharge plan’ to ensure discharges are timely and effective

NHS England captures data on DTOCs monthly. Although we haven’t found a breakdown by day of the week, there have been “reductions in the volume of delayed transfers of care in the last year”.

It’s too early to pass judgement on the effectiveness of the Long Term Plan in tackling DTOCs at weekends, so for now this is ‘in progress’. We’ll keep tracking to see if we can justify moving this to ‘done’ – follow this policy for updates.

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