Delayed transfer of care (DTOC) among the older population

Karen Jones Completed   2019


A ‘delayed transfer of care’ (DTOC) occurs when a patient has been delayed at least one day after they were medically fit to be transferred/discharged (NHS England, 2016). According the National Audit Office (NAO) (2016), there has been an increase of 270,000 bed days involving patients in acute hospitals with a delayed transfer of care, leading to a significant impact on both the social and health care sectors. The National Audit Office (2016) estimated that delayed transfers among older people cost the NHS up to £820 million every year, with many requiring social care support from their local authorities (LAs) following discharge. At a time of financial austerity, there is a need for the health and social care sectors to work together to reduce, or prevent, DTOC.

This project aims to investigate why DTOC occurs, and how they might be reduced or prevented. The project is exploring:

  1. Current discharge arrangements (across LAs and the NHS) and the relationship between specific discharge approaches and local DTOC rates. The aim is to assess which approaches are effective in reducing or preventing DTOC;
  2. The relationship between DTOC rates, home care expenditure by LAs, and home care and residential care supply.