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Delayed Discharge

The Scottish Government is committed to significantly reducing the number of people in Scotland who are waiting to move from hospital wards to more appropriate settings. 

Why do people become delayed discharges?

Delays can occur for a variety of reasons, but are usually due to a lack of appropriate care or services available within the community. For example, there may not be a place available in a local care home, or a person's house may need altered to help them get around.

Delayed Discharge monthly census

From June 2015 information on delayed discharges, including the reason for and length of delay, is published in a monthly census by NHS National Services Scotland's Information Services Division (ISD). These statistics were published quarterly prior to June 2015:

Bed days occupied by delayed discharges

Data on the number of bed days lost to delayed discharges  (the days between being 'ready for discharge' and the actual date of discharge) has been published by ISD since August 2012 and is used as an additional measure.

Bed days lost data covers the whole calendar month and includes bed days associated with delays that would not be captured in the snapshot census. From June 2015 bed days lost data is published monthly, alongside the monthly snapshot census.

Why do we want to reduce delays?

No-one wants to remain in hospital any longer than they need to. A long delay can often lead to the patient falling ill again, or losing vital life skills, independence or mobility. It could ultimately result in the patient having to be admitted to a care home due to the deterioration in their health and mobility.

Helping local partnerships reduce delays

Targets were announced by the Cabinet Secretary for Health, Wellbeing and Cities Strategy in October 2011. The target aimed to ensure that no patient was unnecessarily delayed in hospital for longer than two weeks by April 2015.

The Scottish Government and Joint Improvement Team provide a range of practical support, guidance and toolkits to help local partnerships reduce the level of patients delayed in their hospitals:

We have invested £100 million over three years, from 2015-16 to enable new Integration Authorities to deliver on the integration indicators, which include a commitment to increase the percentage of delays discharged within 72 hours of being ready for discharge.

Discharge with 72 hours of being ready

There is evidence that people who are delayed more than 72 hours have worse outcomes than those who go home sooner. The current two week target is not ambitious enough for the majority of people should be able to return home, with simple community support - generally within 72 hours of being ready for discharge.

However, discharge planning for people with complex support needs will, quite rightly, take longer. Many people with complex care and support needs will have experienced delerium, or loss of confidence and independence in hospital, but may have potential for further recovery, in the right setting. These people can benefit from the provision of intermediate care provided at home, or in a homely setting like a community hospital or care home.

A Core Suit of Indicators have been developed alongside the Public Bodies (Joint Working) (National Health and Wellbeing Outcomes) (Scotland) Regulations 2014.

One of the indicators will measure the percentage of people who are discharged from hospital within 72 hours of being ready for discharge. Focusing on this measure, alongside the number of bed days lost to delay, will ensure the delivery of better outcomes for people.