Data collection guidance

Discharge Ready Date is the date that a patient no longer met the ‘Criteria to Reside’ in a hospital bed.

The ‘Criteria to Reside’ are set out in Annex D of the ‘Hospital discharge and community support guidance’ document on the GOV.UK website: Annex D criteria to reside – maintaining good decision-making in acute settings.

The Discharge Ready Date should ideally be completed for all inpatients with a stay of one night or longer, i.e. overnight stays, who have been assessed and no longer meet the Criteria to Reside. However, for those patients discharged on the same day as their discharge ready date (i.e. there was no delay), providers may leave the Discharge Ready Date field unfilled.

The Discharge Ready Date may be earlier than the Discharge Date if the patient does not meet the Criteria to Reside and their condition does not deteriorate but they remain in the hospital bed.

Once it has been agreed that a patient no longer meets the Criteria to Reside, i.e. a Discharge Ready Date has been agreed, this should be reviewed during every ward round whilst the patient remains in a hospital bed to ensure that the patient continues to not meet the criteria.

A patient may again meet the Criteria to Reside in a hospital bed if their hospital stay is prolonged. Where this is the case:

• For finished episodes of care, the Discharge Ready Date should record the start date of the final period that the patient no longer met the ‘Criteria to Reside’ in a hospital bed for that episode of care.
• For unfinished episodes of care, the Discharge Ready Date should record the start date of the current period that the patient no longer met the ‘Criteria to Reside’ in a hospital bed, if applicable for the current episode of care. 

The Discharge Ready Date is a different data field from the Discharge Date which records the actual date of discharge from a hospital spell. These may be the same date, for example if the patient is discharged on the day the patient first no longer meets the Criteria to Reside.

The settings from where the discharge may originate are a health service hospital or inpatient unit or an independent hospital in pursuance of arrangements made by an NHS body.

The above definition replaces the previous version based around the provisions of the Community Care (Delayed Discharges etc) Act 2003, which was repealed by the Health and Care Act 2022.

For those patients discharged on the same day as their discharge ready date (i.e. there was no delay), providers may leave the Discharge Ready Date field unfilled. A small number of exclusion criteria apply where a delay calculation will not be made (see the frequently asked questions section below).

Example scenarios

Example 1: A patient in a hospital bed no longer meets the Criteria to Reside in hospital and is discharged the same day

Patient A is admitted into a hospital bed on 01/08/2023. At this point they meet the Criteria to Reside.

Two days later, on 03/08/2023, due to their recovery, Patient A no longer meets the Criteria to Reside. The Discharge Ready Date is completed with that date, 03/08/2023.

A short while later on the same day Patient A is discharged from their hospital bed. The Discharge Date should be completed with the date of discharge, which in this example is 03/08/2023.

Example 2: A patient in a hospital bed no longer meets the Criteria to Reside in hospital and is discharged on a subsequent day.

Patient B is admitted into a hospital bed on 05/08/2023.

Two days later, on 07/08/2023, Patient B no longer meets the Criteria to Reside. The Discharge Ready Date should be completed with that date, 07/08/2023.

The following day Patient B is discharged from their hospital bed. The Discharge Date should be completed with the date of discharge, which in this example is 08/08/2023.

Example 3: A patient in a hospital bed no longer meets the Criteria to Reside in hospital but before they are discharged their condition deteriorates so they meet the Criteria to Reside once again. After a further period of recovery they no longer meet the Criteria to Reside and they are then discharged.

Patient C is admitted into a hospital bed on 10/08/2023.

Two days later, on 12/08/2023, Patient C no longer meets the Criteria to Reside. The Discharge Ready Date should be completed with that date, 12/08/2023.

However, later that day Patient C’s condition deteriorates and before they have been discharged, they once again meet the Criteria to Reside. The Discharge Ready Date which was previously populated should be deleted and left blank.

Three days later, on 15/08/2023, Patient C has recovered sufficiently and no longer meets the Criteria to Reside. The Discharge Ready Date should be completed with that date, 15/08/2023.

Patient C is discharged from the hospital bed two days later on 17/08/2023 and the Discharge Date is therefore recorded as 17/08/2023.

Note – Example 3 provides an example of a patient meeting the Criteria to Reside, then not meeting the Criteria, then meeting them again, then not meeting the Criteria, but for some patients this change between meeting and not meeting the Criteria to Reside could happen multiple times. Where this is the case, the Discharge Ready Date should record the start date of the final period that a patient no longer met the Criteria to Reside in a hospital bed.

Example 4: A patient is discharged from a hospital bed whilst still meeting the Criteria to Reside. For example, the patient self-discharges against clinical advice.

Patient D is admitted into a hospital bed on 28/08/2023.

The next day, Patient D is assessed as continuing to meet the Criteria to Reside. Later in the day, Patient D self-discharges from the hospital bed against clinical advice.

The Discharge Date should be recorded as 29/08/2023 with the relevant Method of Discharge recorded (‘6 – patient discharged him/herself’). Discharge Ready Date should be NULL to reflect that Patient D still met the Criteria to Reside at the point of discharge.

Frequently asked questions

Technical questions

1. Do we need to be submitting data using the CDS v6.3 XML schema (i.e., have moved to making CDS v6.3 submissions) to submit the new Discharge Ready Date definition?

Answer: No, Discharge Ready Date can be submitted using the CDS v6.2 XML schema. However, trusts are encouraged to migrate to CDS v6.3 as soon as possible to conform with the CDS v6.3 Information Standards Notice (ISN) and wider data requirements.

 Data collection questions

2. We already record something similar, such as the ‘medically fit for discharge’ date. How does ‘discharge ready date’ differ and do we need to do anything differently?

Answer: CDS v6.3 introduced a change to the definition of Discharge Ready Date, which is now based specifically on a patient no longer meeting the specific, published Criteria to Reside. It is possible that providers may already capture data under a different local system name that fully meets the definition of Discharge Ready Date and therefore can be used for this reporting purpose. Care should be given to ensure all staff groups involved in the collection of this data are aware of the revised definition, terminology, and proposed reporting for Discharge Ready Date.

3. The Criteria to Reside guidance applies to adults only. Should Discharge Ready Date be collected for children and young people?

Answer: Patients over 16 years of age are in scope for the criteria to reside tool (as outlined in Annex D). This is based on the recommendation that NEWS2, one of the components of the criteria to reside tool, should not be used in children (i.e. aged <16 years). Discharge Ready Date should therefore be captured for applicable patients over 16 years of age.

4. Is Discharge Ready Date different to the Estimated Discharge Date?

Answer: Yes, Estimated Discharge Date is a different field which is not captured in CDS and should be recorded separately. Estimated Discharge Date is estimated at the point of admission whereas Discharge Ready Date is recorded on the day the patient no longer meets the Criteria to Reside.

5. Does Discharge Ready Date apply to all specialities provided by the Trust who may have admitted patients staying one night or more?

Answer: Discharge Ready Date is defined according to the Criteria to Reside guidance which applies in relation to adults being discharged from acute hospitals and community rehabilitation units in England, excluding maternity patients. Discharge Ready Date is applicable to all such admitted patients with a stay of one night or more who no longer meet the Criteria to Reside.

Discharges from mental health hospitals are not within the scope of the Criteria to Reside guidance. There is an equivalent metric for mental health called ‘clinically ready for discharge’, and mental health teams should continue to ensure this information flows via the mental health Covid SitRep. The Mental Health Services Data Set (MHSDS) also collects ‘clinically ready for discharge’ data as part of the version 6.0 update.

6. Does a Discharge Ready Date still need recording for patients who are discharged without any delay, i.e., where Discharge Ready Date is the same as Discharge Date?

Answer: Discharge Ready Date should be recorded for all in scope patients who have been assessed as no longer meeting the Criteria to Reside. For those patients discharged on the same day as their discharge ready date (i.e., there was no delay), providers may leave the Discharge Ready Date field unfilled. A small number of exclusion criteria apply where a delay calculation will not be made (see question 7 below).

7. Is a Discharge Ready Date entry expected for patients who still meet the Criteria to Reside at the point of discharge from the hospital bed? E.g., Self-discharge.

Answer: No, if a patient still meets the Criteria to Reside at the point of discharge, then a Discharge Ready Date is not applicable and should not be entered.

Example scenarios include:

• Method of Discharge = Patient died/patient discharged themselves/patient discharged by a relative or advocate
• Acute-to-acute transfers for ongoing acute care in the same or different provider.