A new Royal College of Physicians survey reveals three in four physicians reported delays in discharging patients, with difficulties accessing social care placements, rehabilitation support and safe housing among the leading barriers. The RCP warns that these problems will place further pressure on hospitals this winter.
Patients who are well enough to leave hospital can spend days or even weeks waiting for the care and support they need outside it, new findings from the Royal College of Physicians (RCP) show.
The findings come as Prime Minister Andy Burnham announced a £40 million programme to help GPs provide additional support to vulnerable patients this winter, aiming to prevent avoidable hospital admissions and ease pressure on NHS services.
While preventing unnecessary admissions is essential, the RCP warns that tackling winter pressures also requires urgent action to address delays in discharging patients who no longer need hospital care.
Three-quarters (76%) of RCP members surveyed in June said they had experienced delays in discharging patients in the previous month.
Among respondents:
• 61% reported delays arranging social care or community support
• 56% reported delays finding rehabilitation, care home or nursing home places
• 46% reported problems involving housing, safeguarding or finding a safe discharge destination
• 39% reported family-related factors affecting discharge planning (e.g. family disagreement or support unavailable)
• 33% reported delays accessing mental health support or transferring to mental health settings.
Delayed discharge has been shown to significantly impact health outcomes. Patients left waiting in hospital after they are medically ready to leave face risks including infections, falls, physical deterioration and loss of independence.
Research published in the Journal of Hospital Infection found four cases of hospital-acquired pneumonia for every 1,000 days patients spent awaiting discharge at a Welsh hospital. Among patients who developed hospital-acquired pneumonia, 39% died, compared with 7% of those who did not. NHS England July 2026 guidance warns that unnecessarily prolonged hospital stays can leave patients increasingly dependent on long-term social care.
With winter expected to bring increased demand for urgent and emergency care, the RCP is warning that existing bottlenecks in hospital discharge could place even greater pressure on NHS capacity.
RCP survey respondents
One physician responding to the RCP survey said a patient who was medically ready to leave hospital waited 28 days for a social worker to be allocated, another seven days for a best-interests meeting and a further 14 days while a placement was found.
A hospital-acquired norovirus infection during the delay prolonged the admission by another week.
Another physician described a patient whose acute medical treatment had been completed but who remained in hospital for several weeks because his previous care setting could no longer support him, and an alternative placement had not been found.
Doctors also reported patients waiting for mental health beds and specialist psychiatric support, including people detained under the Mental Health Act, who could not be transferred to an appropriate setting.
The RCP warns that the consequences reach far beyond individual patients. When people remain in hospital after they are medically fit for discharge, capacity for urgent and emergency care and planned care is stretched, leading to the increase in unsafe and undignified practices such as corridor care.
Dr Hilary Williams, RCP clinical vice president, said:
‘Far too many patients who are ready to leave hospital remain stuck there because the care and support they need outside it isn't available. Every unnecessary day risks harming their recovery and means a bed cannot be used by somebody else waiting for treatment.
‘We welcome the measures announced this week to help prevent avoidable hospital admissions this winter, but reducing the huge pressure facing hospitals also means ensuring patients can leave safely when they are ready. Our findings show that shortages in social care, rehabilitation and suitable accommodation can leave patients waiting for days or even weeks.
'Patients and their families deserve better. This is not the fault of overstretched staff across health and social care. It is a system-wide failure that hospitals cannot solve alone as winter approaches. There are a wide range of issues across health, social and community care contributing to these delays. A lack of capacity across the system, coupled with fragmented pathways and an ageing population with multiple health conditions, is compounding the problem. Longer-term reform of health and social care is essential, but patients and NHS staff are dealing with these pressures now.
'The Prime Minister has rightly acknowledged this is not going to be an easy winter for the NHS. The government needs to make sure services are coordinated, families are supported, and that there is capacity to support patients when they are ready to leave hospital.'
Dr Zuzanna Sawicka, RCP clinical director for patient safety and clinical standards, added:
'The longer someone stays in hospital once they are medically fit to leave, the greater their risk of picking up an infection, losing their mobility, or becoming confused. This is a particular problem for older and frailer patients, who may then require rehabilitation to regain their mobility, independence, and confidence.
'Patient safety is not only about what happens on the ward. It is about making sure people can move on to the right care, in the right place, at the time they are ready for that care. A lack of coordination and provision of safe discharge destinations is currently failing patients.
‘We must listen to the patients and staff experiencing this every day, and we need action now before the even busier winter period.'
The RCP has consistently highlighted the need for greater investment in community-based care and stronger integration between health and social care services.
In February 2025, the RCP warned that tackling delayed discharges would require urgent social care reform and greater investment in community services. Its RCP view on neighbourhood health report published in May 2026 also called for properly resourced multidisciplinary teams that bring together hospital physicians, GPs and community services to plan patient journeys that prevent delays transferring between services.