Empowering Integrated Care

A Path to Reducing Delayed Discharges and Delivering Better Outcomes

By Greg Brown, Owner and Registered Manager of Home Instead Reigate & Tandridge

Prepared as a thought leadership contribution ahead of the Surrey County Council and Surrey Heartlands Integrated Care Board Think Tank.

Delayed discharges from hospital, where patients medically fit to leave remain in beds, are costing the NHS billions each year and putting vulnerable individuals at risk. Yet, this long-standing issue is not simply a matter of logistics or funding. It’s a systemic failure of coordination between health and social care services.

At Home Instead Reigate & Tandridge, we believe it’s time for a radical rethink, and recent policy recommendations offer a timely opportunity to turn words into action.

At any given time, around 15% of NHS general and acute hospital beds are occupied by patients who no longer need acute care. That’s roughly 15,000 beds, costing the system over £2 billion annually. More importantly, these delays are detrimental to patient well-being.

Elderly patients, especially those with dementia or acute mental health issues, face significant harm from prolonged hospital stays; deconditioning, hospital-acquired infections and emotional confusion are common consequences.

The causes of delayed discharge are well known; inadequate hospital flow management, poor coordination across care sectors, and a lack of community-based reablement and rehab services. But what’s often overlooked is that these issues stem from fragmented accountability, outdated governance and under-leveraged independent care capacity.

A Financial and human cost we can no longer afford

Keeping someone in a hospital bed costs around £4,000 a week. Compare this to £1,500 in a care home, or even less with quality home-based care, and the economics speak for themselves. But the real value is in better outcomes: people recover faster at home, with care tailored to their needs, provided by familiar, well-matched Care Professionals.

Our experience tells us that independent providers already deliver better outcomes. Why? Because our model prioritises continuity, companionship, and quality over volume.

At Home Instead Reigate & Tandridge, our visits are typically two hours long, with Care Professionals matched to clients for compatibility. We pay our team well, because good care depends on well-supported people. Yet, we are often excluded from Local Authority (LA) commissioning because our model doesn’t fit the lowest-cost procurement formulas.

This must change.

Integration is the only way forward to break the cycle

Fragmentation between the NHS and LAs lies at the heart of this crisis. The latest policy proposals rightly advocate for Better Care Fund (BCF) allocations to be contingent on integrated delivery and measurable outcomes, reduced delayed discharges, shorter length of stay and improved patient experience.

This integration is not just a strategic ideal. It’s a necessity. By pooling budgets, aligning commissioning strategies, and adopting collaborative management structures, the NHS and social care can finally work as one system. Section 75 agreements already provide a legal route for this, but they must be mandated and enforced.

Regions need to play a critical role, identifying accountable discharge leads, ensuring proper data flows and applying performance-based incentives. This means naming the executives responsible for reducing delays and giving them the authority and tools to act across organisational boundaries.

Empowering the Independent Sector

To succeed, integration must fully include the independent care sector. We are not simply contractors; we are care partners. Our local knowledge, flexibility, and commitment to personalised care make us ideally positioned to support intermediate care pathways and reduce hospital readmissions.

Yet, as it stands, independent providers are often left out of strategic discussions. This is a mistake. Policymakers must recognise that excluding those already delivering high-quality outcomes undermines the entire system.

At Home Instead Reigate & Tandridge, we’re ready to be part of the solution. We invest in training, technology and a culture of compassion. Our clients thrive in familiar surroundings and their families benefit from peace of mind.

Technology and ransparency

Real-time data is essential. Better digital infrastructure, such as predictive analytics and integrated discharge planning tools, can transform flow management and ensure that patients aren’t delayed due to poor visibility of community resources. Moreover, publishing performance data will drive local accountability.

We also champion transparency with families. Our own technology allows family members to stay informed, track visits, and feel connected to their loved one’s care, even from the other side of the world.

A unified vision for local change

The recommendations in a recent paper by the Chair of Surrey Heartland Integrated Care Board, should be a wake-up call. Integration, accountability, and outcome-driven commissioning are not abstract goals, they are the only way to create a sustainable, compassionate health and care system.

Greg Brown and those contributing to the Think Tank, want to see the break down of barriers between sectors and to recognise and reward what works. And especially to ensure that vulnerable elderly patients no longer spend weeks in hospital unnecessarily when a safe, effective alternative exists at home.

Home Instead Reigate & Tandridge stands ready to lead, collaborate and care. Now is the time to make joined up care the norm, not the exception.

To explore partnership opportunities or learn more about how quality homecare can support system goals, contact Greg Brown, Owner and Registered Manager, at [email protected].