SUMMARY

Patients are categorised according to the main reason for their continuing stay in the hospital ward at the time of the current census.
 

• The number (71) of patients outwith the six week discharge planning period who were waiting to go home (e.g. awaiting re-start of services or new services; awaiting social support (eg carer); awaiting procurement/delivery of equipment/adaptations; or
  
• Specialist Housing provision) is 8% lower than the number (77) at the same point last year but 8% higher than the number (66) at the July 2006 census).
  
• The number (73) of patients outwith the six week discharge planning period who were awaiting funding for a care home placement is 47% lower than the number (139) at the same point last year but 18% higher than the number (62) at the July 2006 census).
  
• The number (300) of patients outwith the six week discharge planning period who were awaiting place availability for a care home/specialist residential facility placement is 17% lower than the number (362) at the same point last year
  
• and 9% lower than the number (330) at the July 2006 census).
  
• The number (22) of patients outwith the six week discharge planning period who were in the Healthcare Assessment/Arrangements reason is 52% lower than the number (46) at the same point last year but 47% higher than the number (15) at the July 2006 census).
  
• The number (72) of patients outwith the six week discharge planning period who were exercising statutory right of choice is 25% lower than the number (96) at the same point last year but 89% higher than the number (38) at the July 2006 census).
  
• The number (25) of patients outwith the six week discharge planning period in the Legal/Financial reason categories is 19% lower than the number (31) at the same point last year but 14% higher than the number (22) at the July 2006 census).
  
• The number (93) of patients outwith the six week discharge planning period in the Community Care Assessment reason category is 2% higher than the number (91) at the same point last year and 31% higher than the number (71) at the July 2006 census
  
• The number of patients outwith the six week discharge planning period in the short stay specialties was 59 and 620 in the non-short stay specialties.

ADDITIONAL NOTE:
From October 2006 three changes have been made.
 
NHS board and Local Authority Partner information, previously published as two reports, will be presented in one report. This has resulted in some renumbering of the tables, the number of self-funders are no longer reported on, a new table of information on short stay and non-short stay specialties by NHS Board of treatment will be included [see table 4].
 
Note also that delayed discharges for the former Argyll and Clyde Health Board continue to be shown in two parts headed Argyll (NHS Highland) and Clyde (NHS Greater Glasgow). It is planned that this will continue until the April 2007 report.


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MAIN CONTACTS:

Caroll Brown
Data Analyst
0131 275 6099
Caroll.Brown@isd.csa.scot.nhs.uk


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PRE-RELEASE ACCESS TO THIS PUBLICATION WAS GIVEN TO:
NHS Chief Executives, Directors of Social Work, NHS Contacts, Local Authority Partner Contacts, NHS Leads, NAGoDDI Representatives.


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GLOSSARY:
Ready for discharge
A patient is ready for discharge when he/she is judged to be clinically ready to move on to the next stage of care (note that the 'next stage of care' includes destinations within and outwith the NHS). The definition covers both NHS hospital beds and beds contracted for NHS use in non-NHS facilities.
 
Patients ready for discharge over six weeks
For most Local Authority Partners there is an accepted period beyond the clinically ready for discharge date during which all assessment and follow-on arrangements are put in place.  The common period for discharge planning is six weeks, however locally this may differ for Local Authority Partners. Each Local Authority Partner agreement is designed to reflect local circumstances and arrangements for safe and appropriate transfers of patients to the next stage of care.  For this reason the Scottish Executive Health Department, recognising the complexity which can surround the discharge planning and assessment process, have advised that whilst there should be no change in the national definitions, only data for those patients who have been ready for discharge for more than six weeks at the time of the census should be published in comprehensive form in the quarterly figures.  Summary information on ‘total’ numbers of patients ready for discharge including those patients with a delay of less than six weeks at the time of the census will continue to be published.
 
Ready-for-discharge date
This is the date on which an inpatient is clinically ready to move on to the next stage of care. This date is determined by the consultant/GP responsible for the inpatient care, in consultation with all agencies involved in planning the patient's next stage of care -whether or not assessments by health and social care agencies have been completed. NB Multi-agency discharge planning can be complex. The aim of the community care assessment process is to ensure that the patient's post-hospital care needs are met in full and this may require input from a range of health and social care agencies, as well as taking account of the patient's own wishes and family/carer issues. Aids and adaptations required for the patient's own home can also be a major consideration.
 
Reason
This is the reason why the patient has remained in the bed awaiting the finalisation of arrangements for his/her safe transfer. For the national census, the principal reason that applies to each patient at the census point is recorded.
 
Social Work Involvement
A patient ready for discharge is considered to have Social Work involvement if: EITHER - he/she has Principal Reason 'Community Care Assessment' or 'Community Care Arrangements'; OR - he/she has Principal Reason in the 'Patient/Carer/Family - related' categories, OR Principal Reason not agreed, OR Principal Reason not recorded AND a date of referral for Social Care Assessment has been recorded.
 
Duration
This is the period of time to the census point that the patient has remained in the bed awaiting the finalisation of arrangements for his/her safe transfer.
Median/mean duration presentation, and frequency distribution
This publication presents information on durations up to the census point. Two summary measures are provided:
Median duration - the middle value of any one set of duration values that are arranged in numerical order.
Mean duration - an average duration, calculated by summing all duration values in any one set and dividing by the number of cases in that set.
The frequency distributions for duration commonly show a relatively large proportion of cases experiencing fairly short durations and a relatively small number with longer durations. The median may therefore be taken as the best indicator of a "typical" duration for patients in a particular group (eg a particular NHS Board, or a particular reason category).



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HISTORY OF THIS PUBLICATION:
Last Published: 31st Aug 2006     -    Next Due: 27th Feb 2007     -      First Published: The first census was taken on the 15 September 2000 and the report is available at
http://www.isdscotland.org/delayed_discharges


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KEY WORDS:
Delayed Discharges, Patients ready for Discharge, Joint Future