Mr. Bernard Gloster:

Yes. There are three components to what would be called an improved, or improving, DTOC management position. The first is the available options outside of the hospital for people who require some support when they leave, whether it is home support, home care packages, home help, or indeed nursing home care. The availability is one part that dictates it. The second part that dictates it is effective decision-making within the hospital where it is flagged early that a person is heading for discharge but if he or she does not get particular supports they will end up in DTOC. A best-practising hospital will do what is called predicted day of discharge, PDD. The key to the best practice is actually outside the hospital then, it is in the community healthcare organisation, or CHO, as we call them. The best practising CHOs are the ones who have their staff embedded in the hospital and managing the patient's discharge from the time it is indicated right out to the point the patient gets to where he or she is going.