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Blog from Dr Vin Diwakar, Medical Director for Transformation, NHS England

Once people no longer need hospital care, their home or a care home is the best place for them to continue their recovery. However, unnecessary delays in being discharged from hospital are a problem that too many people experience: every day fewer than half of people who are ready to leave hospital return home, or to a care home.[1]

We want to make sure that people who no longer need to be cared for in hospital leave in a safe, effective, and timely way. I would like to invite you to share your ideas on this question: what should always happen to ensure people go home from hospital earlier in the day and be heading #Home4Noon?

My recent personal experience of a stay in hospital highlights some issues that get in the way of people heading #Home4Noon: I was ready to be discharged at 9am, but I left at 5pm, having spent the day on the ward because of waiting for medicines I needed to take home. This meant someone in need of that bed that day was unable to use it.

People across the NHS – regions, systems, and providers of services - are currently working together on a range of initiatives to understand the reasons why people don’t always leave hospital when they are clinically ready; how we can work together to address the issues; as well as identifying and sharing where good work is already happening.

Heading #Home4Noon is one of the initiatives. People who are ready to be discharged from hospital should leave as early in the day as is possible, and ideally be heading #Home4Noon. This provides a better experience for the person receiving care because there is less waiting around in hospital, they will be arriving home during the daytime, and they can be settled into their home environment with everything from shopping to equipment that they will need already in place.

Heading #Home4Noon is also useful for those people who are waiting to come into hospital either for an operation, or following assessment in the emergency department. Being admitted earlier in the day means they too have a better experience because they are settled into the ward and their family can visit them.

There is a direct relationship between the percentage of patients who discharge and leave the hospital by noon and overcrowding and risks to patients and our staff in emergency departments and acute units in the evening and at night.

As an acute clinician, I also know that organising our services to achieve heading #Home4Noon is not as easy as it sounds!

I’d like to invite anyone with an interest in making sure people heading #Home4Noon becomes the norm rather than an ambition: do join in here: https://solvingtogether.crowdicity.com/  There are three challenges: People, Teams, and Organisations, including systems. Please visit the challenge area to read more about these challenges, and share your ideas. Your ideas can include examples of good practice, innovative ideas, or experiences of care; I am very much looking forward to reading them.

Heading #Home4Noon is part of #SolvingTogether which is an approach to capture, assess and test learning and ideas that can support the priorities for health and care; it is part of a suite of interventions relating to the delivery of transformation led by Tim Ferris, Director of Transformation of NHS England. It is doing this by mobilising the people who know the most (those delivering and receiving care and leading services), making them fair, accessible and inclusive for all.

The #SolvingTogether “crowdsourcing” platform is a regionally-led and centrally supported initiative to capture, assess, test and share ideas on a range of issues affecting our NHS.

Heading #Home4Noon is part of the 100 Day Discharge Challenge, which aims to support trusts and systems to adopt 10 best practice initiatives to support hospital discharge. NHS and social care staff can access a range of resources to help them implement the initiatives in their own organisation on a new dedicated website.

Take part...have your say, let’s get #SolvingTogether and with your help we can get people heading #Home4Noon and #ImprovingDischarge

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This post was edited on Feb 13, 2024 by Solving Together