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The impact of short-term residential care home beds on delayed transfer of care (DTOC) among older patients


A delayed transfer of care (DTOC) occurs when a patient is medically fit but there is a delay in moving them out of hospital. The National Audit Office (2016) estimated that 85% of individuals recorded as a DTOC were aged 65 and over, which costs the NHS as much as £850m every year. Evidence suggests that DTOC can lead to an increased need for social care following discharge at a time when Local Authorities are required to reduce budgets. Budget reductions on the supply of residential care beds and home care can have an impact on transferring patients out of hospital. 


The availability of short-term care beds could impact on the timely organization of care packages outside of hospital leading to a reduction of local DTOC rates. 


This project bridges the gap in evidence by exploring the relationship between the availability of short-term residential care home beds and local DTOC rates.


  • Explore whether the availability of short-term residential care home beds facilitates the timely transfer of patients out of hospital (DTOC).


The project involves inviting managers of residential care home organisations to participate in a telephone interview to explore discharge arrangements and the factors that facilitate or inhibit the timely transfers of patients out of hospital.

It uses official DTOC data submitted to NHS England by NHS Trusts, NHS Foundation Trusts and Social Enterprises. The dataset will be populated with additional secondary data, including:

  1. Care home and home care availability

  2. Informal care availability

  3. LA care home and home care expenditure

  4. LA-level need and demand characteristics (e.g. population, pension credit uptake, carer’s allowance, Disability living allowance, house prices).


Data exploring the availability of short-term residential care beds will be collected from managers of residential care home organisations. 

The availability of appropriate secondary data about short-term residential care beds will be explored, and analysed to explore the effects of supply/availability on DTOCs.


Karen Jones (Lead), Elizabeth Welch and Gintare Malisauskaite


  • Start Date: January 2019

  • End date: December 2020

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