• Significant changes at Bolton NHS Foundation Trust helps to halve time to get patients home
• Work has seen delayed days fall from 1,100 to 516 within ten months
• Discharge Unit has supported upwards of 3,000 patients back home since opening in August 2024

The time it takes to get patients out of hospital and back to the comfort of the place they call home has halved thanks to significant improvements that have taken place behind the scenes at Bolton NHS Foundation Trust.

Integrated discharge teams at the Trust have increased their capacity to support the timely discharge of patients who are medically fit.

This work has resulted in the number of delayed days falling from 1,100 in February 2024 to 516 in December 2024, meaning 500 days of people being in the place they call home, instead of Royal Bolton Hospital.

Other changes to help support patients home and free-up bed space for other patients include:

• 20 new beds opening in the Dove Unit, Mill View, increasing capacity in the community for those patients who require further care in a different setting.
• Introducing 7-day consultant led working on wards so that there is always a senior clinician able to determine whether a patient is able to leave hospital care or not.
• Additional Multidisciplinary Teams (MDTs) at a weekend, including a consultant, and therapeutic input. This has led to a 72% increase in weekend discharges.
• Increasing the number of social workers doing patient assessments on our wards, to understand what a patient needs in order to be discharged safely, so that this can be arranged as soon as possible.
• Twice weekly meeting with system partners to discuss patients with extended stays to help unblock complex barrier to discharges.
• Created strong links with teams in Bury, Salford and Wigan to ensure their residents get back to the comfort of their own home.

Integrated discharge teams are made up of a number of different teams within the Trust, as well as social care teams at Bolton Council whose role is to support the patients leaving hospital care once they are well enough.

Cheryl Thompson, Reactive Care Lead at Bolton NHS Foundation Trust, said:

Many patients that leave our care have really complex needs in terms of the support they need on discharge, which is why it can sometimes take some time for them to be discharged once they’re medically fit.

“Our hospital teams work closely with the council, community organisations and patients’ relatives to understand where the best place is for people who are well enough to leave hospital care and continue their rest and recovery at home.

“We know people who stay longer in hospital are at a high risk of harm and infection, and by recovering in a place they comfortable and familiar with we can reduce their risk of deconditioning, which can impact their ability to do daily activities of living.

“Our teams do everything they can to make sure people can return home as soon as possible to aid patient recovery and keep our hospital system moving.

In August 2024, the Trust opened a new dedicated Discharge Unit to reduce delays for people leaving hospital, free-up bed space and improve patient experience while they wait to return to the place they call home.

More than 3,000 patients have been discharged through the unit since September, with an average of 30-40 patients passing through each day.

Tracy Darbyshire is among the patients to have used the Discharge Unit, after being admitted to hospital for severe pain: “I initially came in because I’d been having excruciating stomach pain, I had to call an ambulance.

I was bought here, and the staff have been amazing, I can’t fault them. I’m being discharged today, and I want to let the staff know how grateful I am for their help.

“I can’t fault my stay – it was like a four-star hotel – I’ve felt safe and was informed every step of the way.

The Discharge Unit has capacity for 18 seated patients, and benefits from cubicle spaces to accommodate patients on beds and trollies to maximise comfort, privacy and dignity.

Richard Webster, Matron, said:

Since opening in August, we have been able to safely discharge thousands of people through this unit, where they have been able to move away from the busier ward environments and into a comfy and calm environment whilst they wait any medication or transport home.

Our patients in the unit continue to receive any care they need and we’re pleased that the response has been overwhelmingly positive, with patients telling us how it’s helped them to feel at ease.

“The unit has only been open for a few months and we look forward to working with colleagues across the Trust in 2025 to understand how we can go even further in improving flow through the hospital and enhancing what our patients and their families experience.

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