Variability and performance of NHS England's 'reason to reside' criteria in predicting hospital discharge in acute hospitals in England: a retrospective, observational cohort study

NHS England (NHSE) advocates 'reason to reside' (R2R) criteria to support discharge planning. The proportion of patients without R2R and their rate of discharge are reported daily by acute hospitals in England. R2R has no interoperable standardised data model (SDM), and its performance has not been validated. We aimed to understand the degree of intercentre and intracentre variation in R2R-related metrics reported to NHSE, define an SDM implemented within a single centre Electronic Health Record to generate an electronic R2R (eR2R) and evaluate its performance in predicting subsequent discharge. Retrospective observational cohort study using routinely collected health data. 122 NHS Trusts in England for national reporting and an acute hospital in England for local reporting. 6 602 706 patient-days were analysed using 3-month national data and 1 039 592 patient-days, using 3-year single centre data. Variability in R2R-related metrics reported to NHSE. Performance of eR2R in predicting discharge within 24 hours. There were high levels of intracentre and intercentre variability in R2R-related metrics (p