Fit to leave, forced to stay: what’s driving delayed hospital discharge in Europe?
3 September 2026
A worsening social care crisis is leading to delayed discharges, affecting people and health systems. So what needs to change?
Delayed discharges are costly for everyone. They overwhelm health systems, forcing the cancellation of planned treatments and placing additional strain on the workforce. This leads to people waiting for beds in emergency rooms, and hospitals failing to address the backlog in elective care. And people stuck in hospital are also at increased risk of infection, and declining mobility and mental health – all of which bring about even more costs and worse outcomes.
Why can’t people get discharged from hospital?
There are many reasons why discharge from hospital might be delayed, including issues with transport or the availability of medication; wellbeing concerns; transfer processes that haven’t been decided or completed; or, outside the hospital, services that are simply not available.
But one of the main reasons is poor access to long-term care: help with day-to-day living due to illness or disability; meal delivery services; adaptations to the home (such as personal alarms); carers who make home visits; supportive living services and care homes.
People who can't go home without support, and need a care home placement or home modifications, have nowhere else to go – so they remain in hospital.
How does a lack of long-term care contribute to delayed discharges?
Discharging people who need additional help at home requires a highly coordinated system to make sure they get the right support, at the right place, at the right time. People who can’t go home without support, and need a care home placement or home modifications, have nowhere else to go – so they remain in hospital.
It is not clear how many discharges are delayed due to a lack of data. Countries do not agree on what a delayed discharge is, and comparable data barely exist. The NHS stopped separating out reasons for delays between health and social care in 2020. However, we do know that in April 2024, waits for care home beds and home-based care accounted for 45% of the delays in discharges for people who had been in hospital for two weeks or more. This amounts to almost 4,000 people who are medically fit to leave being stuck in hospital every day.
A similar picture exists in other countries. In Italy, for example, one study found that 52.7% of people whose discharge was delayed were waiting for a place in long-term care, rehabilitation or a residential care home. In the Netherlands, surveys in three Amsterdam hospitals found that waiting for a care home place was among the most common reasons people stayed longer than they needed to.
The way forward
Long-term care systems in Europe are in crisis. They suffer from underfunding, an overstretched workforce and services that don’t join up with hospitals.
At EU level, the 2022 Council Recommendation on access to affordable, high-quality long-term care set a shared framework for reform. Some countries have already moved; Norway has quantified the cost of delayed discharge using linked health and social care data to make the case for investment. This built on its 2012 Coordination Reform, which requires municipalities to pay hospitals a daily fee for patients who are fit for discharge but remain in hospital.
There is little access to help with day-to-day living, such as meal delivery services; adaptations to the home (including personal alarms); carers who make home visits; supportive living services and care homes.
Outside the EU, England has committed to reforming The Better Care Fund (BCF) and has provided a framework for 2026–27. One of the purposes of the BCF is to support people to live independently for as long as possible; this support includes health and social care services, which should help prevent avoidable hospital admissions, and facilitate community and mental health hospital discharge. NHS England also published Neighbourhood Health Guidelines 2025/26, which provides a framework for more community-based care, so people can maintain independence. One of the aims of the framework over the next five to ten years is to help the NHS and social care work together to reduce unnecessary waits in hospitals and connect people with wider public services and social support.
While this progress is promising, urgent action is still needed to address delayed discharges. A key challenge is the lack of comparable data or clear definitions of delays in discharge, which limits the ability of health and care systems to track the scale of the problem and identify the investment needed to solve it. The WHO Europe/European Commission’s State of Long-Term Care toolkit, developed to support the Council Recommendation, is a step in this direction. It offers countries a shared glossary, implementation guide and data collection template. But despite this guidance, data on delays to discharge do not appear to be collected or published by EU Member States.
Once people are medically fit for discharge, having long-term care readily available would help them rehabilitate; greatly improve outcomes; free up beds for people who urgently need them; and support more efficient and effective healthcare down the line. We already know what is needed. Now we must implement and monitor these actions to ensure people, health systems and society can benefit.