Understanding Referral Rejections: Barriers to Discharge in Complex Care
- Lewis RTC
- Jul 31
- 3 min read
Updated: Aug 1
Across the UK, trusts and local authorities continue to face mounting pressure
to free up hospital beds and improve patient flow. For individuals with complex needs, these challenges are particularly acute. When a suitable onward placement isn’t available, or when referrals are declined due to complexity or system constraints, discharges are delayed. Over time, the effects of these delays ripple far beyond the individual.
At RTC, we support the system by stepping in at these critical points. Through close partnership with registered providers, NHS teams, and care commissioners, we help facilitate safe and stabilising transitions out of hospital, even when longer-term arrangements are still being finalised.
Why Referrals Are Rejected
Referral rejections typically aren’t about unwillingness, they’re about capacity, compatibility, or risk. Common reasons include:
A lack of suitable placements or providers equipped to manage complexity
Safeguarding and regulatory concerns
Ongoing risk assessments or legal constraints
Delays in funding approvals or panel decisions
These are not easy decisions for any team to make. But when rejection results in someone remaining in hospital for weeks or even months longer than clinically necessary, it creates further complications.
The Consequences of Delay
Each day spent waiting for discharge can have a measurable impact. Individuals may experience:
A decline in emotional or behavioural stability
Increased dependency on inpatient routines
Disruption to relationships with family or existing community professionals
Missed windows for stabilisation and engagement with therapeutic input
At a system level, the effect is equally significant. Discharge teams are under increasing strain, hospital capacity becomes constrained, and placement options further down the line may fall through due to changing circumstances.
The Value of Timely Discharge
When someone remains in hospital longer than necessary, the consequences go far beyond operational pressures. For individuals with complex needs, delays can lead to a decline in mental wellbeing, increased dependency, and a breakdown in long-term planning efforts.
Discharge teams face growing pressure to move patients on, but without suitable options in place, the system becomes gridlocked. It’s not just the patient affected, frontline staff, bed availability, and future placements all feel the knock-on impact.
RTC offers stabilising care that enables movement. We work closely with NHS teams, local authorities, and registered providers to support safe discharge and provide consistent care during transition. Our role is to create the right environment for progress while permanent solutions are identified and implemented.
Working in Partnership
We understand the pressures services face — and the importance of shared responsibility when managing complex discharges. RTC collaborates with providers, commissioners, and frontline teams to:
Support safe, phased discharges from inpatient settings
Hold and stabilise individuals with complex needs while long-term planning continues
Maintain care continuity in the community through structured, agreed support
Bridge service gaps without bypassing regulatory expectations
We are not a replacement for regulated care, nor do we offer open-ended placements. Our model is rooted in partnership, enabling individuals to move forward safely while systems work to secure long-term, sustainable arrangements.
Let’s Talk
If you're facing referral challenges, delayed discharges, or increasing system pressure, we’re ready to support. Our approach is collaborative, stabilising, and focused on long-term outcomes.
Get in touch to learn more about how we work alongside NHS trusts, local authorities, and care providers to strengthen discharge pathways and improve capacity across the system.
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