Delayed Discharges
29th May 2007
Patients Ready for Discharge in NHSScotland - figures from April 2007 Census
INTRODUCTION:
This release summarises the results of patients ready for discharge from a 'snapshot' of NHS inpatients as at the April 2007 census.
Patients are categorised according to the main reason for their continuing stay in the hospital ward at the time of the current census.
KEY FINDINGS:
Figures from April 2007 show that 233 have been ready for discharge for over 6 weeks at the April 2007 census. This is 62% less than the number (606) at the January 2007 census and 53% less than the number (498) at April 2006 [see Interpretation].
The number of patients outwith the six week discharge planning period who were awaiting place availability for a care home/specialist residential facility placement has decreased considerably there were 124 cases at the April 2007 census, compared with 277 at the January 2007 census, and 220 at the April 2006 census
The number of patients outwith the six week discharge planning period in the Community Care Assessment reason category has decreased there were 28 cases at the April 2007 census, compared with 92 at the January 2007 census, and 70 at the April 2006 census.
INTERPRETATION:
In July 2006 there was a change in definition for patients who had a planned discharge date within 3 working days of the census, these cases are no longer defined as a delayed discharge and have been omitted from subsequent census totals. At the time of the July 2006 census the effect was 22 cases in this category. This change should be taken into account when making comparisons between April 2006 and April 2007.
DETAILED SUMMARY:
The number of patients outwith the six week discharge planning period who were waiting to go home has decreased has decreased there were 22 cases at the April 2007 census, compared with 51 at the January 2007 census, and 54 at the April 2006 census.
The number of patients outwith the six week discharge planning period who were in the Healthcare Assessment/Arrangements reason categories has decreased. There were 6 cases at the April 2007 census, compared with 18 at the January 2007 census, and 8 at the April 2006 census.
The number of patients outwith the six week discharge planning period who were exercising statutory right of choice has decreased there were 26 cases at the April 2007 census, compared with 59 at the January 2007 census, and 46 at the April 2006 census.
The number of patients outwith the six week discharge planning period in the Legal/Financial reason categories has decreased there were 7 cases at the April 2007 census, compared with 16 at the January 2007 census, and 15 at the April 2006 census.
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).
Caroll Brown
Data Analyst
Tel: 0131 275 6099
Caroll.Brown@isd.csa.scot.nhs.uk
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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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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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HISTORY OF THIS PUBLICATION:
Last Published: 27 February 2007
Next Due: 28 August 2007
Data Available Since: The first census was taken on the 15 September 2000 and the report is available at http://www.isdscotland.org/delayed_discharges
Caroll Brown
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