Could a single shared success unit across health and social care help reduce the vast cost associated with delayed discharges or ‘bed blocking'? Recent estimates put this figure as high as £2bn each year.

Real costs could be far higher in terms of damaged lives through increases in infection (a product of lengthy hospital stays) and the permanent loss of independence.

A vast amount of policy and research has already been written on this subject but to little avail. Despite improvements in practice and leadership heft being added (DHSC guidance advocates the appointment of a person directly reporting to the executive) to the equation delays can be extensive and harmful to health, well-being and finances.

 Perhaps surprisingly, there is no shared universal success measure: different stakeholders want different things, some of which are incompatible.

Hospitals measure bed occupancy rates. Delays impact directly on their ability to provide care and treatment. They also measure infection rates and loss of independence both of which can be worsened by longer stays. Care homes also look at occupancy rates where empty rooms mean lost income.

Families, those who would care for ill elderly relatives, value their own time; a returning older parent needing support will eat directly into their personal time and possibly impact on their income. There must also be a degree of out of sight, out of mind syndrome – meaning that someone else is caring for someone who could present significant post-hospital challenges.

Housing providers, who have very little spare capacity to play with, will value the absence of pressure. And patients will measure success in a variety of ways, mostly to do with getting better and returning to some kind of independent life.

Interestingly, not only is there no shared success unit but the same person will adopt different labels depending on where they are in the system – patient, service user, client, tenant and so on.

But what if there was a single unit that focused on the most important element in a person's journey: the return to optimal independent life (OIL). Optimal rather than ideal would recognise that not everyone will get back to full health and independence.

An OIL score of 1 would mean a person was able, post-hospital, to return to the best possible state of independence. Anything less than 1 would mean support in some form or other.

Having a shared focus would be important from the first day of admission with all the stakeholders (medical, care, housing, relatives and the person) all setting out what a post-hospital OIL scenario would look like. Importantly, the expected OIL would be set out at the beginning and used to ensure all partners are accountable.

An MDT-type meeting would look at the likely pathway for the person given their condition, the expected care plan, the timeline and the support work that would need to be put in place by all parties sequentially to achieve a high OIL score. This would be the place where relatives could be asked about their capacity for support. This would be a cards-on-the-table session, devoid of unrealistic promises and primed for all parties to commit to a deliverable plan.

Perhaps this could help overcome the current blockages: paperwork out of synch with care availability, patients being passed from pillar to post and an overall lack of a single party to hold accountable.

Each OIL plan would have a single owner with enough organisational weight to hold everyone else accountable for delivery. As well as being accountable directly to the person (patient/tenant/client etc) to ensure that all promises are kept, they would also produce reports to the executives of each key provider.

If such an approach yielded results, then some of the money saved could be used to support the implementation of OIL plans – additional budgets to contract providers of housing, care or family support - £2 bn could go a long way to smoothing the way to better processes.

Of course, a single integrated approach to health and social care designed at national level and implemented locally which would create an entitlement for individual citizens might be better. But arguments over boundaries, budgets and accountabilities are likely to ensure that won't happen any time soon.