Before you launch: test with a few people, then make it simpler
Small usability tests and simpler forms are two of the cheapest ways to improve a new website, app or digital product before launch. Here is how to do both.
Hospital discharge: where flow gets stuck, and what helps
Most people leave hospital on the day they are ready. For those who do not, delays usually build up where teams hand over to each other. Here is what the latest figures show, and where I think practical help makes a difference.
Why discharge matters to everyone
Getting people home from hospital when they are ready is good for them, good for their families and good for the NHS. Every extra day in hospital is a day away from home, and a bed someone else is waiting for. I have spent eight years in senior roles at home care and live in care companies, working with NHS trusts, GPs and councils on exactly this, and it remains one of the most important problems in our health and care system.
What the latest figures show
NHS England now publishes monthly data on how quickly people leave hospital once they are ready.
- In August 2026, 85.7% of patients discharged from acute hospitals left on the same day as their discharge ready date. 14.3% left one or more days later. [S38]
- For patients whose discharge was delayed, the average wait from being ready to leaving was 6.4 days. [S38]
- Delayed discharges added up to 306,740 bed days lost in acute hospitals that month. [S38]
- NHS England's daily situation reports show that in September 2026, on average, 13,647 patients a day remained in hospital although they no longer met the criteria to stay. NHS England describes this data as management information. [S39]
So the picture is mixed. Most people leave on time, but those who do not can wait a long while, and the total effect on hospital capacity is large.
Why delays build up
The Nuffield Trust's QualityWatch programme looked at the reasons behind longer delays. It found that "In 2025, capacity issues were the leading cause of hospital delays across all lengths of stay, affecting nearly 3,700 patients a week who stayed in hospital for 7 days or more." It also notes that long stays affect "how the wider health system works, by causing delays to admission from A&E, which in turn increases ambulance handover and response times." [S40]
Social care is central to this. The King's Fund reports that in 2024/25 "there were 2.0 million requests for support made by people new to social care", and that "Around 4 in 5 requests originate from the community, with most of the remainder (17%) coming from hospital discharge." [S41]
In practice, leaving hospital often depends on several things coming together at once: an assessment, a referral, a provider with capacity, equipment or adaptations at home, and a family who understands the plan. Each handover is a chance for a delay.
Home first
National guidance is clear about the direction. The Department of Health and Social Care and NHS England say: "Under the discharge to assess model and home first approach to hospital discharge, the vast majority of people are expected to go home (that is, to their usual place of residence) following discharge." [S42]
Home first only works if support at home can start quickly and reliably, and if families know what to expect.
Where practical help makes a difference
Decisions about whether someone is ready to leave hospital are clinical, and they are not ours to make. But much of what slows discharge sits around those decisions, in processes, information and communication. That is where I think organisations can make real progress.
- Map the journey with the people who run it. From ward to front door, find where time is lost, where information is retyped and where nobody owns the next step.
- Share one picture each morning. Simple dashboards built from data teams already hold, so hospital, council and provider teams are looking at the same thing.
- Make handovers digital and clear. Referrals, updates and confirmations that reach the right person first time.
- Help families prepare. Plain English information on what happens next, who to call and how to get the home ready. Our own app, Coming Home: Family Care, includes questions to ask the ward, a home readiness list and a shared 30 day plan for exactly this reason.
- Help suppliers explain themselves. Providers of home care, equipment and adaptations need to be easy for discharge teams to understand and contact.
A joined up problem needs joined up help
Patient flow is not just a hospital problem. It connects to whether care providers can keep their clients and keep their staff, which is why we treat patient flow, client retention and carer retention as three views of the same journey.
You can read more on our Patient flow and retention page, or book a discovery call to talk about a pathway you want to improve.
Sources
- NHS England, Timeliness of Acute Hospital Discharges (Discharge Ready Date), August 2026, published 9 October 2026. [S38]
- NHS England, Acute discharge situation report, September 2026, published 8 October 2026. [S39]
- Nuffield Trust, QualityWatch: Delayed discharges from hospital, updated 4 June 2026. [S40]
- The King's Fund, Social care 360: access, 8 April 2026. [S41]
- Department of Health and Social Care and NHS England, Hospital discharge and community support guidance, updated 26 January 2024. [S42]
Let's talk
Got an idea, a product or a process that needs to move?
Tell us where you are and what you need. A free discovery call is the easiest way to find out whether we can help.
