By Tinga Umera, Managing Director, Nexus Care Services
Every winter the same picture plays out across the NHS, as A&E departments fill up and ambulances queue outside.
Much of the conversation focuses on the front door of the hospital, but far less attention goes to the back door, yet that is often where the system gets stuck.
However, we will have to wait to see how that pans out and right now, nearly 13,000 people a day are in hospital beds in England despite being medically fit to leave.
That is close to one in ten beds, which the King’s Fund put at a cost £2.7 billion a year due to delays, with a single bed day now costing the NHS £562.
As a home care provider that has worked alongside NHS discharge teams at Good Hope Hospital and many other local clinics and departments for more than a decade, we see the other side of those numbers.
Behind every delayed discharge is a person who wants to go home and often a family waiting anxiously for news.
It is tempting to see delayed discharge as a hospital problem, but the data suggests otherwise.
Nuffield Trust analysis shows that in 2025 a lack of capacity was the leading cause of delays, affecting nearly 3,700 patients a week who had been in hospital for seven days or more.
In those cases, the discharge plan had been agreed, but the care needed to make it happen was not yet available.
That is where home care comes in as a provider, such as us, can pick up a package quickly and safely, a bed is freed and a person gets home.
In our experience, a good home care partner adds value at every stage of the journey home.
Nexus Care Services has been supporting people across Sutton Coldfield, Lichfield, Tamworth and the wider West Midlands for more than a decade.
We now deliver over 2,500 care calls every week to more than 200 people and supporting hospital discharge has been a core part of our work with local NHS partners throughout that time.
Over the years we have built the relationships and processes that make fast, safe discharge possible.
Where possible, we assess new referrals within 24 to 72 hours and our digital care planning means information is shared quickly and accurately with everyone involved.
Just as importantly, our team knows local discharge teams well, which makes the handover smoother for patients and their families.
With the launch of our nurse-led complex care service in September, we can now also support people with clinical needs at home.
That includes people who might previously have waited longer in hospital for a suitable package of care.
A hospital bed is the right place when someone is acutely unwell, but it quickly becomes the wrong place once they are ready to leave.
NHS guidance is stark on this point and for someone over 80, ten days in bed can mean the equivalent of ten years of muscle ageing. Even 24 hours of bed rest may reduce muscle power by 2.5 per cent.
For an older person who was managing well at home before admission, a few extra days on a ward can be the difference between returning to independence and needing far more support.
NHS England recognised this in its Model Discharge Pathway, published in July, which is clear that staying in hospital longer than necessary causes harm.
It also calls for local teams to work more closely with hospitals on early discharge as neighbourhood-based care develops.
The evidence for getting people home sooner, with the right support in place, is encouraging.
Discharge to Assess, often called Home First, moves the assessment of a person’s ongoing needs out of the hospital and into their own home.
At home, in familiar surroundings, it becomes much clearer what they can manage for themselves and where they need a hand.
Speed on its own is not the goal, though, as a quick discharge that falls apart after a few days helps nobody.
Healthwatch has repeatedly heard from people who left hospital without the information or follow-up support they were promised. The aim has to be a transition that is both prompt and properly supported.
Delayed discharges rise every winter and have peaked each January since 2022. There is little reason to expect this year to be any different.
Our message to NHS partners and commissioners is simple: talk to us early. The sooner home care is part of the conversation, the sooner people can leave hospital and the more beds are free for those who need them.
For families facing a loved one’s discharge this winter, home is very often the best place to recover, as long as the right support is waiting there. If you would like us to support you with a hospital discharge into home care, please get in touch.
We genuinely believe that our carers provide the best service available.
If you need care in Sutton Coldfield, Tamworth or Lichfield, please get in touch with our friendly and approachable team.
