2018 Delayed Transfers of Care Conference review

Our second tranche of conferences for 2017/18 began with Delayed Transfers of Care, a new project for the Network building upon the Older People in Acute Settings project. The timely and pertinent topic encouraged lively discussion within the room and evidenced the need for benchmarking in this area.

The conference was opened by Dwayne Johnson, Director for Social Care & Health at Sefton Council and Chair for ADASS Older People Network. His presentation set out the national figures, stating that Local Government Authorities reported 26% of admissions were able to be avoided in 2017. Dwayne highlighted the reduction in social care expenditure and diversion of funding to other areas within council spending impacting DToCs; following which, he presented the opportunities in social care to counteract delayed transfers of care. These include a joint set of priorities, partnerships and investment in the community, NHS and social care.


We then heard from Tom Luckraft, Assistant Head of Planning Delivery, and Calum MacGregor, Senior Planning Delivery Officer, representing the Hospital to Home Team from NHS England. They presented the next steps for Delayed Transfers of Care with regard to the Five Year Forward View and the targets set for the year, consequently improving flow through the healthcare system. NHS England have formed a new Counting Group, to reduce the disparity in data reporting around DToCs, as well as refining the terminology to improve the reporting of patients through the system.

Following the national update, the NHS Benchmarking team presented the Delayed Transfers of Care project findings, split between Acute, Community and Mental Health sectors. We are pleased that 67 organisations participated in the first full DToC project, with submissions from three UK countries. It was interesting to hear the comparison in reasons for delayed transfers of care across the three sectors, including ‘awaiting family choice’ and ‘awaiting care package at home’. You can look at your organisation’s position using the toolkit on the members’ area. There will also be a survey circulated to our members consulting on the future of the DToC project – all responses are appreciated.


Following a networking lunch, we heard from three good practice speakers. Calderdale & Huddersfield NHS Foundation Trust mirrored the opportunities set out in the first session by Dwayne Johnson, encouraging better pathways between services in their Safer Patient Flow programme. Their activity in managing DToCs with a fit for purpose database and better network of professionals has reduced their patient length of stay, for which they have been recognised.

Southern Health & Social Care Trust followed, with a focus on the Home First ethos. The good practice highlighted cross-professional working and shared protocols, including two effective information systems, reducing delayed transfers of care in both the step up and step down referral process. Interestingly, a model where discharges are managed from the community, rather than from the acute hospital, was presented.

The final good practice came from Medway NHS Foundation Trust, on their whole system management of DToCs. The Trust has implemented an emergency pathway to deliver improved flow through their emergency department. However, the pivotal change within the Trust was the implementation of a daily DToC senior multi-agency Executive teleconference, which has impacted greatly on their figures.

We circulate your good practice case studies on a quarterly basis. If you would like to share your innovative working with the membership, please contact e.pruce1@nhs.net for more information.

Absolutely excellent opportunity to learn and share experience. Real lessons to take back.
— Member feedback

The reports for Delayed Transfers of Care will be available in March. If you have any project queries, please contact Lucy Trubacik, Assistant Project Manager. Thank you to all who submitted to the project and attended the conference in both a delegate and presenter capacity.

If you are interested in any of our future events, please contact Emma Pruce.