Nottinghamshire County Council - Case Study

Nottinghamshire County Council delivers adult social care services to communities across Nottinghamshire, supporting vulnerable individuals to live independently and access the care they need. The council works closely with three major acute hospital trusts to coordinate approximately 10,000 complex hospital discharges each year that require social care support.

With service users needing timely transitions from hospital to community-based care, Nottinghamshire needed a digital solution that would reduce delays, eliminate manual processes, and enable health and social care teams to work from the same information.

Social workers were spending up to 60% of their time chasing information through phone calls, faxes, and emails. Individuals medically fit for discharge were waiting an average of four days, occupying hospital beds unnecessarily.

Without a direct connection into social care systems, hospitals couldn't see whether referrals had been received or what actions were being taken.

Nottinghamshire partnered with Access to implement Discharge to Assess, a digital referral solution built on Access's cloud-based interoperability platform. The solution was created to support the hospital discharge process by digitising and streamlining the end-to-end workflow.

Discharge to Assess enables electronic referrals from hospitals to flow securely to Mosaic, Access's leading social care case management system, supporting safe hospital discharge when social care is required.

Digital Referrals

When an individual in hospital needs social care support for discharge, hospital staff create a digital referral that transmits information to Mosaic. This includes key details such as current ward location, medically fit status, predicted discharge date, and specific discharge requirements.

Integration with Hospital Systems

The digital referral connects with the hospital's Electronic Patient Record (EPR) system, enabling updates to flow into Mosaic when an individual's status changes. This helps ensure social care teams have access to current information.

Integrated Workflow

This integration philosophy extends beyond the referral itself. Updates, case notes, financial information, and outcomes tracking all sit within Mosaic, supporting joined-up care coordination.

• The referral process is quicker, saves staff time and means patients can be discharged sooner into social care.
• Over 1,000 admin hours saved per year across multiple organisations.
• The integration brought consistency to different processes across three acute hospitals.
• All updates are stored in one easy-to-access Mosaic form.
• Once the digital referral is sent, and the patient information is linked to the hospital’s EPR so social care teams are notified of changes instantly. This means the social workers are looking at the same information as to their colleagues in the hospital.
• All information is now stored in Mosaic and fully reportable in automated business reporting dashboards, which were created by Nottinghamshire.
• The patient data in Mosaic also feeds a live case management tracker to allow more efficient monitoring of cases across teams, removing the need for multiple spreadsheets and manual data entry to manage caseloads.
• The average length of time between a patient being medically fit for discharge and being discharged is reduced, from four days to two days on average.
• The patient’s health and wellbeing are improved as they receive the appropriate care in the community or at home much faster.

Health and social care professionals can prioritise the right patients for discharge when they are safe to leave the hospital, reducing the risk of discharge delays and aiding bed management.

Katy Ball explains how Nottinghamshire's technology-enabled care strategy is transforming outcomes, with over 50% of people drawing on care and support now benefiting from technology integration.

Halving Hospital Discharge Times

Average discharge time has been cut in half, representing hundreds of saved bed days annually.

Melanie Brooks, Corporate Director for Adult Social Care and Health: "Nottinghamshire has been a trailblazer in developing a solution that enables social care staff to view up-to-date health information, saving time and enabling quicker, safer discharges."

Supporting Residential Care Avoidance at Scale

The integrated approach linking Discharge to Assess with Nottinghamshire's wider technology-enabled care strategy has delivered remarkable results. In just the first four months of the 2024/25 financial year, over 180 people assessed as very likely to need care quickly were able to remain safely at home thanks to technology-enabled support coordinated through Mosaic.

As Katy Ball notes: "We've got lots of wonderful stories of difference from people about how technology is really helping. Most of those people said they just felt so much more confident and didn't want to even think about having to be anywhere other than their own home. That's the power of using technology to help people meet their goals."

Mark Douglas, Technology Enabled Care Manager, oversees approximately 3,000 technology-enabled care referrals annually from adult social care staff, including teams based in the three acute hospital trusts. The Council introduced a "tech first" principle governed by two clear parameters: "If we put tech in, it should maintain or improve outcomes for people, and it should be value for money. We're not going to put tech in if we don't think it's going to make people's lives better."


Mark Douglas explains how integrating everything through Mosaic has been fundamental to achieving over £2.175 million in net savings while improving resident outcomes.

Substantial Benefits for Unpaid Carers

89% of unpaid carers report reduced stress levels in council surveys. Laura Chambers from Nottinghamshire County Council explains: "We've found over time that by trying various different products, we are universally able to show back to family and loved ones that someone often has more capacity and capability than they feared that they did. This empowers the person and the family to feel safer in the knowledge that the person is safe in their own home."

Strengthened Partnership Working

Discharge to Assess has changed how Nottinghamshire County Council and the three hospital trusts work together, bringing consistency to different processes across three acute hospitals. Hospital discharge coordinators and social workers can now access the same information, enabling more effective joint decision-making and reducing discharge delays.

Evidence-Based Financial Returns

Through rigorous evaluation and systematic data collection via Mosaic, Nottinghamshire has demonstrated a net saving of £2.175 million from its technology-enabled care services. The council tracks outcomes at an individual level, calculating actual costs of keeping people at home versus residential care placement costs.

As Mark Douglas explains: "We can say, person A, if they're assessed as a high risk of a residential care admission, they're still at home six months after that initial assessment. So we can then look at the cost of a residential care placement and take away from that the actual costs at individual person level to keep that person in their own home."

This evidence-based approach gave the council confidence to shift from purely cost-saving objectives to a "tech first" principle focused on both improved outcomes and value for money.

Nottinghamshire continues expanding the platform to support Continuing Healthcare assessments, mental health crisis pathways, and predictive analytics.

Katy Ball: "There's definitely a future where we all want more interoperability, connecting products and hardware that make it easier for staff to have information at their fingertips."

Nottinghamshire's experience shows how integrated digital solutions can reduce discharge times by 50% while achieving millions in cost savings. Discover how Access interoperability solutions can support similar transformations.