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Discharge challenges reflect district nurse ‘underinvestment’, says QICN Around a quarter of patients are not getting enough support from health or social care services after being discharged from hospital, the healthcare watchdog has warned. A new national patient survey carried out by the Care Quality Commission (CQC) has today revealed ongoing difficulties around discharge planning and post-discharge care in the community. The Queen’s Institute of Community Nursing (QICN) said the findings ‘underline the consequences of sustained underinvestment’ in community services and show the need for greater funding for community and district nursing services. The 2025 adult inpatient survey captures the views and experience of more than 58,000 people who stayed in one of 130 acute and specialist NHS trusts in England for at least one night during November last year. It has been carried out annually since 2002. Hospital discharge has been listed under the CQC’s ‘key areas for improvement’ after survey results showed a quarter (24%) of respondents did not get enough support from health or social care services to help them recover or manage their condition after leaving hospital. This was up from 23% in 2024. Related Article: Nurses’ jobs at risk from older people’s care unit closure, union warns The survey also found that some 22% of respondents reported not having a discussion with hospital staff around whether they would need any further health or social care services after leaving hospital, despite having wanted this to happen. A further 21% who thought it was necessary said hospital staff did not involve their family or carers in decisions about them leaving hospital at all, with a further 17% saying they were ‘not very much’ involved. More than a quarter (26%) of respondents who thought it was necessary said their family or carers were not given the information they needed to care for them at home, the CQC added. QICN chief executive Steph Lawrence said the findings on discharge support ‘should be a significant concern for health and care leaders’. ‘Too many people are leaving hospital without feeling they have the support they need to recover well or manage their condition at home,’ she told Nursing in Practice. Ms Lawrence highlighted the ‘vital role’ played by community and general practice nurses in supporting people post-discharge, including ‘helping them recover safely, manage complex health needs and avoid unnecessary readmissions’. ‘However, community nursing services are facing unprecedented demand, workforce shortages and increasing patient complexity,’ she said. ‘When community teams are overstretched, there is a greater risk that people leaving hospital will not receive the level of follow-up, monitoring and support they require. ‘While discharge is a whole-system responsibility involving hospitals, community health services and social care, these survey findings underline the consequences of sustained underinvestment in community services as a whole. Related Article: Nurses and families urged to speak out over children’s nursing shake-up ‘For example, the longstanding challenges facing social care, including workforce pressures and insufficient funding to meet rising demand, also have a significant impact on people’s experiences of discharge and recovery at home.’ She pointed to the QICN’s ongoing concerns around ‘care not done’ in community nursing. ‘This occurs when nurses are forced to make difficult decisions about which aspects of care can be delivered because there is simply not enough time or capacity to meet all identified needs,’ said Ms Lawrence. ‘It is not a reflection of nurses’ commitment or standards, but of the pressures facing services.’ As the government looks to shift more care closer to home, Ms Lawrence once again stressed the need for ‘greater investment in community nursing, including district nursing services, to ensure patients receive timely, safe and effective care after discharge’. ‘Without action to address workforce shortages and rising demand, the gap between the care people need and the care services can provide will continue to widen,’ she warned. Related Article: NHS trust makes changes to district nursing services after coroner’s concerns ‘Patients should be able to leave hospital confident that the support they need will be there when they get home. ‘Strengthening community nursing capacity is essential to making that ambition a reality.’ Last year the CQC issued a warning over the shortage of district nurses, claiming the situation was driving ‘task-based’ care and risks undermining the government’s plans to shift care from hospital settings into the community. See how our symptom tool can help you make better sense of patient presentations Click here to search a symptom