Page last updated: 28-AUG-2007

Delayed Discharges


Statistical Publication Notice

28 August 2007

Nat_stat_1

Patients Ready for Discharge in NHSScotland figures from July 2007 census  


INTRODUCTION

This release summarises the report on NHS inpatients "ready for discharge", but whose discharge has been delayed, from a census of these patients as at the July 2007. A delayed discharge occurs when a patient, clinically ready for discharge, cannot leave the hospital because the other necessary care, support or accommodation for them is not readily accessible and/or funding is not available, to purchase a care home place, for example.Patients are categorised according to the main reason for their continuing stay in the hospital ward at the time of the current census. Explanation of the technical terms used in this notice are in the glossary below.

KEY POINTS

There has been a considerable decrease in the number of patients delayed outwith the six week discharge planning period over the last six years. The October 2001 census is the point when the figures were at their highest, there were 2,162 patients delayed compared to 423 patients at the July 2007 census, a reduction of 80%. The latest figures of 423 are 190 higher than the number (233) at the April 2007 census and 204 less than the number (627) at the July 2006 census.

The largest ‘principal reason for delay’ group of patients delayed outwith the six week discharge planning period, concerns availability of a care home/specialist residential facility placement. There were 185 cases at the July 2007 census, compared with 124 at the April 2007 census, and 330 at the July 2006 census.

INTERPRETATION

Following a review, NHS Shetland has re-classified a group of patients who were previously assumed to have ‘Complex Needs’ and, by definition were excluded from the main census. From July 2007 census these patients will be recorded, more appropriately, in the main report. It has not been possible to identify the effect of this change retrospectively for comparison purposes but it may be helpful to note that the numbers for NHS Shetland are relatively small and the impact nationally is accordingly negligible.

DETAILED FINDINGS

The number of patients delayed outwith the six week discharge planning period in the various principal reason categories, all of which showed increases compared with April 2007, were as follows:

  • Availability of a care home/specialist residential facility placement: there were 185 cases at the July 2007 census, compared with 124 at the April 2007 census, and 330 at the July 2006 census.
  • Community Care Assessment: there were 59 cases at the July 2007 census, compared with 28 at the April 2007 census, and 71 at the July 2006 census.
  • Patients’ exercising statutory right of choice: there were 52 cases at the July 2007 census, compared with 26 at the April 2007 census, and 38 at the July 2006 census.
  • Patients’ waiting to go home: there were 39 cases at the July 2007 census, compared with 22 at the April 2007 census, and 66 at the July 2006 census.
  • Patients awaiting funding for a care home placement: there were 55 cases at the July 2007 census, compared with 10 at the April 2007 census, and 62 at the July 2006 census.
  • Legal/Financial reason categories: there were 10 cases at the July 2007 census, compared with 7 at the April 2007 census, and 22 at the July 2006 census.
    [The definition of principal reason can be found in the Data Definitions and Recording Manual at http://www.isdscotland.org/isd/2359.html ].

-----------------------------------------------------------------
 

MAIN CONTACTS:

Caroll Brown
Information Analyst
0131 275 6099
caroll.brown@isd.csa.scot.nhs.uk
 
-----------------------------------------------------------------
 

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).
 

-----------------------------------------------------------------
 

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.
 

-----------------------------------------------------------------
 

HISTORY OF THIS PUBLICATION:

Last Published:  29 May 2007
Next Due:  27 November 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

 

 

Main contact: Email Caroll Brown