Delayed Discharges

Statistical Publication Notice

24 November 2009

Delayed Discharges in NHSScotland (formerly Patients Ready for Discharge) figures from the October 2009 Census.

INTRODUCTION

KEY POINTS

• At the October 2009 census, there were a total of 662 delayed discharges in Scotland, compared with 634 at the July 2009 census and 678 at the October 2008 census.
• There were 94 patients delayed for over 6 weeks in the October 2009 census. This compares with 55 at the July 2009 census and 91 at the October 2008 census.
• The median duration to the census point for all delayed discharges was 22 days (21 days at the July 2009 census and 23 days at the October 2008 census).
• The number of patients experiencing delays in short stay specialties in Scotland has decreased since July 2009. There were 59 at the October 2009 census compared to 65 at July 2009 and 46 at the October 2008 census. 

INTERPRETATION

DETAILED FINDINGS

NHS Board and Local Authority Partner

• Five NHS Boards had no patients delayed outwith the 6 week discharge planning period at the October 2009 census. This compares with six NHS Boards with no patients delayed outwith the 6 week discharge planning period at the July 2009 census and five NHS Boards with no patients delayed outwith the 6 week discharge planning period at October 2008 census.
• At the October 2009 census 18 Local Authority Partner areas had no patients delayed outwith the 6 week discharge planning period. This compares to the July 2009 census when 19 Local Authority Partners had no patients delayed outwith the 6 week discharge planning period and at the October 2008 census when 17 Local Authority Partners had no patients delayed outwith the 6 week discharge planning.  

Principle Reason Category for Delay

Patients Awaiting funding for a care home placement - The number of patients delayed outwith the six week discharge planning period showed the greatest increase of all reason groups since July 2009. There were 41 cases at the October 2009 census compared with 13 cases at the July 2009 census (and 22 at October 2008).

Patients Awaiting place availability in a care home - The number of patients delayed outwith the six week discharge planning period increased in this reason group from July 2009. There were 20 cases at the October 2009 census compared with 16 cases at the July 2009 census (and 31 at October 2008).

Patients waiting to go home - The number of patients delayed outwith the six week discharge planning period increased in this reason group from July 2009. There were 11 cases at the October 2009 census compared with 5 cases at the July 2009 census (and 11 at October 2008).    

MAIN CONTACTS:

Anne Stott
Senior Statistician/Information Analyst
0131 275 6820
Anne.Stott@nhs.net 

GLOSSARY:

Delayed Discharge
A delayed discharge is experienced by a hospital inpatient who is clinically ready to move on to a more appropriate care setting but is prevented from doing so for various reasons. The next stage of care covers all appropriate destinations within and outwith the NHS (patient’s home, nursing home etc). The date on which the patient is clinically ready to move on to the next stage of care is the ready for discharge date which is determined by the consultant/GP responsible for the inpatient care in consultation with all agencies involved in planning the patient’s discharge, both NHS and non-NHS (Multi-Disciplinary Team).   Thus the patient is ready-for-discharge, but the discharge is delayed due to:

• Social care reasons
• Healthcare reasons
• Patient/Carer/Family-related reasons.

Patients delayed more than 6 weeks
It has been agreed for non-short stay facilities that there is a period of 6 weeks beyond the clinically ready for discharge date during which all assessment and follow-on arrangements are expected to be put in place.  During this period:-

1. the completion of the community care assessment may take place
2. the patient may be discharged from hospital
3. the patient may be transferred to another health specialty if their assessed need determines this
4. the patient may be transferred to another health specialty to await discharge from hospital.

Ready for-discharge date
Ready-for-discharge date is the date on which a hospital inpatient is clinically ready to move on to a more appropriate care setting. This is determined by the consultant/GP responsible for the inpatient medical care in consultation with all agencies involved in planning the patient’s discharge, both NHS and non-NHS (Multi-Disciplinary Team). The Team must be satisfied that it is safe and reasonable to transfer/discharge the patient.  A patient who continues to occupy a hospital bed after his/her ready-for-discharge date during the SAME inpatient episode experiences a delayed discharge.

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.

PRE-RELEASE ACCESS:

HISTORY OF THIS PUBLICATION:

Last Published: 25 August 2009
Next Due: 23 February 2010
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: Anne Stott

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