Monthly delayed discharges and cost implications

​Request 820442450

1) By month for each of the last five years (2021-25), how many patients have been deemed medically fit to discharge from Jersey’s General Hospital, but their release has been delayed due to the lack of appropriate ongoing care (for instance, a care home space or at home care package)? Please list these reasons and the number of people it applies to.

2) Please list the length of these delays for each of the last five years (2021-25) and indicate if any are ongoing.

3) For the same time period, please list the amount of money these delays have cost the health service, broken down per year.​

Response

1 and 2

Data for patients recorded as medically fit for discharge from Jersey General Hospital where their discharge was delayed due to unavailability of appropriate ongoing care each month, from November 2023 to December 2025, are detailed in the attached table. 

Information has been derived from historic operational discharge tracking spreadsheets. These records were not originally designed for retrospective statistical reporting, and contain free-text entries with inconsistent terminology and levels of completion. Each case has been assigned a single primary reason for delay, which may not fully capture complex discharge circumstances. As a result, figures are indicative of overall scale and trend rather than definitive counts. 

The figures represent the total number of unique individuals delayed whilst awaiting ongoing care during the month, by care need. Monthly data for delayed bed-days recorded for the period from November 2023 to December 2025.are also provided; these figures give the cumulative number of delayed hospital bed-days attributable to those patients awaiting ongoing care each month, by care need.

It is not possible to report length of delay (delayed bed days) data for the full period from January 2021; historic delayed transfer data extracted from the Electronic Patient Record systems during and around the system transition period did not consistently capture or retain both the date of medical fitness and date of discharge in a structured format. As a result, delayed bed day calculations are not held in a central record and cannot be reconstructed for periods prior to the introduction of the operational discharge tracking records.

Table: Monthly Delayed Transfer of Care data November 2023 to December 2025​

Information on the number of people experiencing a delayed transfer of care whilst waiting in hospital from August 2022 through to October 2023 (inclusive) is available in a Freedom of Information response Numbers of delayed transfer of care since January 2021 (FOI)​​ published to www.gov.je in December 2023.

The response includes a breakdown of these data to show the reason for the delayed transfer of care, along with an explanation of the data limitations and changes in the Patient Administration System / Electronic Patient Record recording options which impact upon reporting capabilities.

As noted in the above referenced response, a patient is considered to be a delayed transfer of care (DTOC) when they have been assessed as medically fit for discharge (MFFD), therapy fit and socially fit. Recording at this level was implemented in Health and Care Jersey’s Patient Administration System in mid-July 2022. Prior to this, only MFFD data was recorded centrally. 

DTOC data for July 2022 is available in a Freedom of Information response Jersey General Hospital delayed discharges (FOI)​published to www.gov.je in September 2022. The response also includes MFFD data from December 2021 to June 2022.

Article 23 of the Freedom of Information (Jersey) Law 2011 has been applied in respect of the information available elsewhere.​

3

It is not possible to report upon the costs associated with delayed transfers of care from records held; though individual patient-level costs may be attributed to an admission as a whole, these are not allocated by days, and therefore, it is not possible to determine the cost to the service after the patient is MFFD but experiencing a delay in discharge. Article 3 of the Freedom of Information (Jersey) Law 2011 applies.

Charges introduced in April 2026 for those choosing to stay in Jersey General Hospital or Samares Ward when deemed medically fit to leave are based upon the average cost of a patient receiving lower level care. Details of the daily charge and the circumstances when this would apply can be found at Changes to healthcare policy.

An approximation of annual costs could be calculated by multiplying the daily charge by the annual number of bed-days delayed.

This charge is intended to encourage patients who are ready to be discharged and have a suitable package of care arranged to move to a more appropriate care setting, helping to keep hospital beds available for those who need them. If a patient chooses to remain in hospital, the charges help cover the cost of their stay.

The King’s Fund recently published their research findings which identify the bed-day cost within NHS hospitals as £562:

New Research From The King's Fund Finds That Delayed Discharges Cost NHS £2,7bn, Up 7.5% On Previous Year | The King's Fund

Articles applied

Article 3 Meaning of “information held by a public authority”

For the purposes of this Law, information is held by a public authority if –

(a) it is held by the authority, otherwise than on behalf of another person; or

(b) it is held by another person on behalf of the authority.​

Article 23      Information accessible to applicant by other means

(1) Information is absolutely exempt information if it is reasonably available to the applicant, otherwise than under this Law, whether or not free of charge.

(2) A scheduled public authority that refuses an application for information on this ground must make reasonable efforts to inform the applicant where the applicant may obtain the information.