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Mental health hospital discharge
Supporting health systems to resolve housing related barriers to leaving hospital
HEALTH, CARE & SUPPORT
Isaac Barry
Associate, Campbell Tickell
Isaac Barry
Associate, Campbell Tickell
Issue 79 | September 2025
The NHS has a central role to play in driving innovation and best practice around supported and independent housing for people with severe mental ill health. We know this because housing is one of the primary factors preventing people leaving hospital in health systems across the country, even where they are clinically ready to do so.
It is not just the inefficient use of limited inpatient capacity or cost that drives the need for the NHS to do more around housing, but the risk to individual patient outcomes when momentum is lost during a pivotal time in recovery. If people don’t have to be in hospital, they shouldn’t be – they should be at home.
While the factors influencing how housing need among patients are understood and addressed vary across the country, there are consistent themes that our consultants come across when supporting strategic and operational change around housing.
“If people don’t have to be in hospital, they shouldn’t be – they should be at home.”
“Too often housing decisions are made without housing, care and support professionals influencing this at the right time.”
Top tips
Our top tips to consider when thinking about improving collaborative work around housing include:
- making sure the right people are in the room when decisions are made – too often housing decisions are made without housing, care and support professionals influencing this at the right time
- developing a shared vision in partnership between people with lived experience, professionals, carers and families – so everyone is talking about and aiming at the same thing
- collaborating with the market to shape capacity and deliver solutions rather than using what is already there. Not doing this risks underserving those with the most complex need
- co-locating or breaking down barriers to collaboration which don’t serve patients, including being smarter about sharing information and data
- thinking long term. This is challenging in environments which are under constant pressure and with reducing budgets, but necessary if systems are serious about delivering change.
Collaboration and co-creation
Many benefits are to be gained by health, local authority, landlords, developers and the voluntary and community sector organisations working together to resolve housing-related discharge barriers. However, the guiding principles and goals of collaboration to improve housing outcomes for people within mental health services must be squarely focused on and co-created by people with lived experience, families and carers.
In cases where NHS organisations are working with partners to implement new approaches to address housing need, these are delivering superb results for their patients and partners.
Across the country, systems are at differing stages of development in this work, with some delivering on co-developed strategies and others in the process of understanding the need for and shape of work programmes for their area. Sussex is a particularly mature system with housing-related discharge delays from acute mental health inpatient settings being reduced from 40% of all delays to just 2% in the 18 months to September 2024 and not having risen above 5% in the months since.
While individual patients may have limited interest in the way resources in the public purse are divided, held and spent by organisations, what they have a right to expect is that those partners work collaboratively to ensure very limited funds are spent wisely on their behalf.
