For those of us working to transform care for people with learning disabilities, autism, and mental health needs, the challenge is clear: too many people remain stuck in hospital settings when they should be living fulfilling lives in their own homes and communities. Despite years of effort, discharges are still too slow, and readmissions remain a stubborn issue.
Commissioners are under immense pressure. The demand for placements is rising, budgets are stretched, and short-term decisions often win out over long-term planning. But we must shift our focus. Getting people out of hospital isn’t just about moving them into any available setting – it’s about creating the right support around them to avoid future crises and readmission.
The Long-Term View: Preventing Readmission
One of the biggest challenges is breaking the cycle of hospitalisation. Too often, people are discharged into settings that are not equipped to meet their needs, only for things to break down, leading to crisis and readmission. This is not just devastating for individuals and their families – it’s also a financial disaster, with huge sums of money spent on repeated hospital stays rather than on sustainable, personalised support.
We need to take a different approach – one that prioritises stability, quality of life, and long-term cost savings. That means commissioners and providers working together to ensure that when someone is discharged, they have the right social care support in place to thrive.
What Does Good Social Care Look Like?
For discharges to be successful, social care providers must be seen as key partners, not just placement finders. The best community-based support includes:
- Truly personalised care – Services should be built around the individual, not the other way around. This means carefully matching people with the right support teams and avoiding generic, one-size-fits-all models.
- Small-scale, flexible support – Traditional residential models don’t work for everyone. Small, bespoke supported living options allow for greater personalisation and adaptability as needs change.
- Investment in skilled staff – Retaining experienced staff who understand complex needs is critical. Without this, continuity is lost, and people are put at risk of instability and crisis.
- Strong family involvement – Families often know what works best but are frequently sidelined in decision-making. Listening to them and co-producing care arrangements leads to far better outcomes.
- Proactive crisis prevention – Crisis planning shouldn’t be an afterthought. Teams need the training, resources, and flexibility to step in early and prevent situations from escalating.
Saving Money by Getting It Right First Time
There is a misconception that personalised, high-quality care costs more. In reality, the opposite is true. When the right support is in place from the start, people are far less likely to end up back in hospital, and long-term costs reduce significantly.
Instead of reacting to crises, we need to shift investment towards sustainable solutions. Commissioners and providers must work together to develop community-based services that prevent unnecessary hospitalisation in the first place. This means:
- Commissioning for long-term outcomes, not just short-term placement needs.
- Investing in community infrastructure, such as specialist supported living and wraparound teams.
- Funding skilled support teams to deliver proactive care rather than relying on emergency interventions.
Collaboration is Key
Bringing people out of hospital successfully requires a shared commitment from commissioners, providers, health teams, and families. It means being honest about what’s not working and being willing to try new approaches.
The LDA Commissioner’s Network is committed to supporting this change. By working together, we can build a future where people aren’t stuck in hospital unnecessarily, where families are heard, and where social care is valued as the foundation of sustainable, personalised support.
It’s time to move beyond quick fixes and invest in solutions that work, not just for today but for the long term. Let’s get this right, together.
Ashleigh Fox
Ashleigh Fox is the Transforming Care Director at Catalyst Care Group, a RNLD, and co-founder of the LDA Commissioners Network. With hands-on experience in delivering high-quality care solutions, Ashleigh is deeply committed to approaches that reduce dependency on paid support, prioritise long-term sustainability, and focus on achieving real outcomes for people with complex needs.
