The latest NHS performance figures reveal that last month, over 420,000 patients who were medically fit for discharge remained in hospital, a staggering 14% increase compared to the previous month.

These patients are often waiting for social care support, such as a bed in a residential care home, but cannot access these services due to a lack of capacity. This alarming rise underscores the consequences of chronic underfunding for social care, workforce shortages, and a fragmented care system that is failing both patients and frontline staff.

The government must tackle the worsening crisis in social care to ensure patients can be discharged safely and promptly from hospital.

Dr John Dean, clinical vice president of the RCP, described the situation as unsustainable: “Every day, thousands of patients remain stuck in hospital beds - not because they need medical care, but because there is simply nowhere for them to go such as a place in a residential care home, or a support package for care in their current home. This is a systemic failure that places intolerable pressure on the NHS.

“Delayed discharges overwhelm emergency departments, force the cancellation of planned treatments, and cause patients unnecessary distress and deterioration in their health. The impact ripples across the entire healthcare system - from paramedics waiting with patients in ambulances to doctors and nurses struggling to find space for those in urgent need.

“This crisis cannot be solved by hospital measures alone. We need a fundamental shift in how care is delivered, with greater investment in community-based models that reduce hospital demand and improve patient outcomes.

“Patients, their families, and the NHS cannot afford to wait another three years for action. If we are serious about addressing the issues highlighted in Lord Darzi’s report, social care reform must happen alongside NHS reform - not after it.”

Regional advisers echo national concerns

Dr Nigel Lane, RCP regional adviser for Severn, said: "In Bristol, where I work, we are seeing the devastating impact of delayed discharges on both patients and staff. When patients remain in hospital longer than necessary, they lose mobility and independence, making their eventual transition to community care even more challenging. Crowded emergency care areas and care in corridors is unacceptable but something that our patients and staff experience frequently. Our hospitals are at a breaking point, and we urgently need a solution that supports patients beyond the hospital doors."

Dr Ben Chadwick, RCP regional adviser for Wessex, added: “The strain on our hospitals is relentless, and the consequences for both patients and staff are severe. Delayed discharges mean that beds remain occupied by patients who no longer need acute care, while those in desperate need of admission face long waits in emergency departments.

“Facing this pressure on a daily basis means that healthcare workers feel that they cannot provide the standard of care they would aspire to. Providing safe and effective care in an overstretched system is as challenging as any time that I can recall. Without urgent investment in community and social care the cycle of delays and overcrowding will only worsen, as will the morale of healthcare workers.”

Delayed discharges are also disproportionately affecting certain groups, such as older people:

Professor Jugdeep Dhesi, President of the British Geriatrics Society, said: "Staying in hospital longer than medically necessary can have a devastating impact on the health and wellbeing of older people, increasing their risk of infection, delirium and physical decline.

“Currently, people aged over 65 account for 62% of hospital bed days, many of whom are waiting for services in the community.

“This means that people are waiting in emergency departments for an available bed in the hospital and can result in care needing to be delivered in corridors. This in turn means that hospitals are not able to address the backlog in elective care, which the Government has identified as a priority.

“Once someone is medically fit to return home, timely discharge with appropriate social care and rehabilitation support in the community greatly improves their chances of recovery.

“Getting healthcare right for older people will benefit the wider NHS."

The recently published Neighbourhood Health Guidelines 2025/26 from NHS England provide a framework for addressing some of these systemic issues. By focusing on people with complex health needs - who account for approximately 7% of the population but drive 46% of hospital costs - the guidelines advocate for integrated neighbourhood teams, improved intermediate care, and enhanced urgent care services. The RCP welcomes these measures and has long called for many of the proposed reforms, including the establishment of neighbourhood multidisciplinary teams.

The RCP has long highlighted the importance of closer working relationships between physicians and social care professionals. Its 2023 report Physicians and social care professionals: working together outlined key steps to improve communication, joint decision-making, and patient-centred care across the sectors. The report emphasises that bridging the gap between health and social care is essential to tackling delayed discharges.

The college also recently raised concerns that the timelines set for the independent commission on adult social care lack the urgency required to address the crisis, arguing that to tackle the issues highlighted in Lord Darzi’s report, social care reform must happen alongside NHS reform, not after it.