Page last updated: 26-MAY-2009

Delayed Discharges

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ONS kitemarkStatistical Publication Notice

26 May 2009

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

INTRODUCTION

This report provides the latest statistics on NHS hospital inpatients "ready for discharge" but whose discharge has been delayed, from a census of these patients as at April 2009. Figures are shown for Scotland and by NHS Board area of treatment and Local Authority partner.
 
Supplementary information on patients reported as having Complex Needs are also presented for Scotland and by NHS Board. The discharge of these patients is considered too complex to facilitate within 6 weeks and therefore they are not included in census totals but are reported separately.
 
A delayed discharge occurs when an individual, 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 were zero patients delayed for over 6 weeks in the April 2009 census. This compares with 79 at the January 2009 census and zero at the April 2008 census.
  • At the April 2009 census, there were a total of 468 delayed discharges in Scotland, compared with 492 at the January 2009 census, and 434 at the April 2008 census. All the patients in the April 2008 and April 2009 census had been delayed for less than 6 weeks.
  • The mean duration to the census point for all delayed discharges was 23 days delayed (28 days delayed at the January 2009 census, and 22 days delayed at the April 2008 census).
  • The number of patients experiencing delays in short stay specialties in Scotland has decreased since January 2009. There were 33 at the April 2009 census compared to 53 at January 2009 and zero at the April 2008 census.

INTERPRETATION

Since reporting began in 2000, changes have been made in the definition and recording of data. Full details of these are included within the Data Definitions and Recording Manual at http://www.isdscotland.org/isd/2359.html?
 

DETAILED FINDINGS

  • All fourteen NHS Boards have zero delays outwith the 6 week discharge planning period in the April 2009 census. This is the first time since April 2008 that all NHS Boards have reached the zero standard. In January 2009 seven NHS boards had delays outwith the 6 week discharge planning period.
  • All thirty-two Local Authority Partner areas have zero delays outwith the 6 week discharge planning period at the April 2009 census. In January 2009 twelve Local Authority Partners had delays outwith the 6 week discharge planning period. The largest decreases in delays outwith the 6 week discharge planning period have been in Glasgow City which had 14 cases delayed in January 2009, East Lothian which had 13 cases delayed in January 2009 and Highland which had 12 cases delayed in January 2009.
  • Patients awaiting availability for a care home/specialist residential facility placement - The number of patients delayed outwith the six week discharge planning period showed the greatest decrease of all reason groups from January 2009. There were 34 cases delayed at the January 2009 census compared with zero cases delayed at April 2009.
  • Community Care Assessment - The number of patients delayed outwith the six week discharge planning period has decreased within this reason group since January 2009. There were zero cases delayed at the April 2009 census compared with 14 cases delayed at the January 2009.
  • Patients waiting to go home - The number of patients delayed outwith the six week discharge planning period has decreased in this reason group since January 2009. There were zero cases delayed at the April 2009 census compared with 12 cases delayed at the January 2009 census.


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MAIN CONTACTS:

Anne Stott
Senior Statistician/Information Analyst
0131 275 6820
Anne.Stott@isd.csa.scot.nhs.uk

Kieran Hudson
Information Analyst
0131 275 6130
Kieran.Hudson@isd.csa.scot.nhs.uk

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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.
 
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PRE-RELEASE ACCESS

Under terms of the ?Pre-Release Access to Official Statistics (Scotland) Order 2008?, ISD are obliged to publish information on those receiving Pre-Release Access (?Pre-Release Access? refers to statistics in their final form prior to publication). The standard maximum Pre-Release Access is five working days. Shown below are details of those receiving standard Pre-Release Access and, separately, those receiving extended Pre-Release Access.
 
Standard (five day) Pre-Release Access:
Scottish Government Health Department (Analytical Services Division)
NHS Board Chief Executives
NHS Board Communication leads
Directors of Social Work at Local Authorities Members of the National Advisory Group for Delayed Discharges Information - NAGoDDI
 
Extended Pre-Release Access:
Scottish Government Health Department (Analytical Services Division)
This extended Pre-Release Access is given to a small number of named individuals in the Scottish Government Health Department (Analytical Services Division). This Pre-Release Access is for the sole purpose of enabling that department to gain an understanding of the statistics prior to briefing others in Scottish Government (during the period of standard Pre-Release Access).
 
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HISTORY OF THIS PUBLICATION:

Last Published: 24 February 2009
Next Due: month 25 August 2009
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 Anne Stott