Delayed Transfer of Care: patient and carer perceptions 

Complementing the older people with frailty theme's Reducing delayed transfers of care project, Dr Helen Smith ran a qualitative study exploring patients' and caregivers' thoughts and feelings about the benefits and harms of hospital stays and of discharge from hospital. 

The findings give insight into factors influencing delayed transfer of care from a patient and carer perspective, as well as early insight into barriers and facilitators that are likely to influence implementation of the NHS Hospital Discharge Service policy. This policy sets out the new ‘discharge to assess’ model to be implemented across England for all people aged over 18 (HM Government, 2020).  


Delayed transfers of care due to family and patient choice are consistently among the top five reasons for delays in discharge from hospital. In February 2020 they represented 16% of all delays in English hospitals (NHS England, 2020). This qualitative study, therefore, focussed on patient and carer perceptions, to complement the systems level focus of the reducing delayed transfers of care project led by the Older People’s theme by colleagues at the University of York.  Tangible recommendations borne out of the findings are being disseminated to stakeholders within our regional Integrated Care Systems.


This study involved qualitative analysis of over 300 stories by older people and their carers of recent hospital stays and discharges, retrieved from Care Opinion, as well as qualitative interviews with 16 older people and/or their carers exploring a recent hospital stay and discharge. This research was carried out during the Covd-19 pandemic, and Dr Helen Smith wrote a blog on her recruitment efforts during this time, which is accessible here: insert blog link.


An accessible summary of the findings is provided in the two resources below. The Frailty Oversight Group provided helpful feedback on the accessibility of earlier versions of these resources. These are now being disseminated to Integrated Care Systems.

More information and further contact

View the visual abstract here: 

Read the key findings booklet here: 

For more information on this project, contact Andria Hanbury at