For the first time, NHS England has put a price tag on the financial burden of delayed hospital discharges, revealing a staggering £220 million cost in September 2025. This figure comes as the health service grapples with growing pressures, where patients deemed medically fit to leave are left waiting for discharge.
While NHS England’s calculation focuses solely on September, an analysis of data from October 2024 shows that the number of bed days lost to delayed discharge was similar across months, meaning the average monthly cost was around £210 million. Over a full year, this adds up to over £2 billion cost to the NHS.
These delays have significant ripple effects throughout the healthcare system, reducing bed availability for new patients, exacerbating emergency department waiting times, and delaying planned medical procedures.
However, the financial implications may be much greater than reported. NHS England cautions that its calculation is likely to underrepresent the issue, overlooking “wider costs” associated with the inability to admit new patients. This includes prolonged waits in A&E and the cancellation of elective care, as well as the detrimental impact on patients trapped in hospitals longer than necessary.
Research suggests that extended hospital stays can adversely affect both the physical and mental health of individuals, highlighting the urgent need for solutions to tackle the ongoing crisis of delayed discharges.
The reasons and their cost
In each month, the biggest factor influencing delayed discharge has been a lack of out-of-hospital capacity, including in social care services, rehabilitation facilities, and care and nursing homes. Only in September 2025 has NHS England put a cost on this – £68m or 31% of the total cost. As out-of-hospital capacity was the leading cause of delay each month and was around the same level, this cost will be similar each month.
Capacity factors were closely followed in September 2025 by Interface Processes, which involved NHS trusts and system partners discussing patients’ onward care, and NHS England estimated this cost the NHS over £62m, or 30% of the total. This includes factors due to both hospital and social care. This factor ranked second, at a similar level throughout the year, and the cost will be similar each month.
Delayed discharges caused by Hospital Processes – such as waits for reviews of need for supported discharge, referral to care transfer hubs or formal decision to discharge – cost £44m, 20% of the total cost in September 2025, also the same level through the previous 11 months, with a similar cost to the NHS.
Issues relating to care transfer hub processes – most commonly waiting for confirmation of immediate care needs and pathway – cost £30m or 14% in September. The remaining £11m (5%) was due to wellbeing or safeguarding concerns. Both these factors were at approximately the same level throughout the year.
Lack of progress
Acute hospital trusts have submitted daily data on reasons for delays to NHS England since early June 2024.
Looking back over 12 months of data (October 2024 to September 2025), it is clear that little has changed in terms of the number of delayed patients or the reasons for their delays. This is despite tackling delayed discharges being a major target for ICBs.
In September 2025, an average of 13,032 patients a day remained in hospital despite being fit for discharge. In the previous 11 months the lowest number was in December 2024 at 11,991 and the highest in February 2025 at 13,717.
Reducing the number of patients with delayed discharge has been a major priority for Integrated Care Boards for some years now, given rising waiting lists, delayed ambulance handovers, overstretched A&E services, and the risks that unnecessary long hospital stays pose to patients. ICBs have begun initiatives, such as virtual wards and closer involvement of the voluntary sector, yet an analysis of the data from October 2024 to September 2025 finds that on average only 40-45% of patients ready to be discharged actually get discharged when ready each month: a level that has remained steady across the time period.
Based on the data, initiatives seem to be having little impact on the level of people languishing in hospitals when they need not be there. It is also clear that a key bottleneck is care outside the hospital.
Action on Social care needed
The CQC’s just published annual State of Care report backs up the fact that the situation in social care is causing delays in discharge of patients. It highlights that the health and social care system “remains fragmented and under severe strain” and that “community services need significant investment in both capacity and capability to deliver the transformation in people’s care” from hospital to the community called for in the government’s 10 Year Health Plan for England.
On the NHS side ICBs are struggling to contain deficits and virtual wards, a flagship policy for ICBs as a way to move patients out of hospital, have even been reported as targets for cuts. Targets have also included contracts with voluntary organisations, who are often involved with home care and hospital discharge.
In the area of social care organised and funded by councils, then ICBs hoping that councils will pick up more of the costs this coming year and also increase capacity will be disappointed. Councils’ social care budgets in England are already under pressure this year, according to the Local Government Association (LGA).
The LGA analysis of spending data shows that demand and cost increases are already outstripping available resources. The LGA has warned Chancellor Rachel Reeves, in a letter ahead of the budget on 26 November, of the financial issues and called for significant additional investment in social care to stave off financial failure, and for reform to boost productivity and efficiency.
A major issue in social care has been staffing, and although the sector vacancy rate has fallen to pre-Covid levels and the number of staff working in adult social care reached a new high in 2024/25, according to a recent report by Skills for Care, this trend has been driven by international recruitment. Changes to skilled worker visas from July 2025 mean that the sector’s staffing will no longer be bolstered by international recruitment. Unless domestic recruitment picks up then the sector’s capacity to care for those discharged from hospital will fall still further.
Yet promises of training to improve recruitment and retention have not materialised, with the Skills for Care report showing the share of care workers in England with a basic qualification has hit a new low due, according to the report, to government cuts to planned training funding. These cuts in training will have an impact as Skills for Care’s report found that receiving training and having a relevant social care qualification were two of five factors which, when present, were associated with significantly improved staff retention.
The CQC’s State of Care report notes that its local authority assurance work has found delays for people in getting access to homecare due to shortages of both homecare staff and in the workforce delivering short-term care to people recovering at home after a hospital stay, which it adds is “consistently the biggest cause of delayed discharges nationally.” It is “more important than ever that a sector-wide workforce strategy is agreed and the recently announced fair pay agreement has an impact.”
The figure of £220m and £2 billion as the cost of delayed discharge is very hospital-focused as is the collection of data in the NHS. How does calculating these figures help with social care capacity, the leading reason for delays for patients ready to be discharged? Dr Arun Chopra, Interim Chief Executive of CQC, notes when discussing the State of Care report that:
“Right now, community services tell us they’re struggling because the way care is funded and organised is designed around hospitals. That’s also true of how data about care is collected and how outcomes are measured. All these things make it harder to move towards care that keeps people well, delivered closer to home.”
He calls for more investment in care outside the hospital, and more emphasis on measuring quality of care, not just the number of procedures. The call for more investment is echoed by Professor Sir Mike Richards, Chair of CQC, who noted that the Casey Commission will be an “important step in reforming social care – but it won’t solve the core funding problem. We continue to call for long-term, sustainable funding for adult social care.”
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