Policy actions  3 of 4

Delayed discharge

We are committed to significantly reducing the number of people who are waiting to move from hospital wards to more appropriate settings. 

Nobody wants to remain in hospital any longer than they need to. Any delay in discharge can have a severely detrimental effect on a person’s health and wellbeing.  

Evidence shows that lengthy periods of unnecessary bed rest can lead to severe muscle wastage, pressure sores, loss of independence and confidence, and can ultimately lead to early admission to a long term care.

Delays can occur for a variety of reasons, but are usually due to a lack of appropriate care or services available within the community. For example, there may not be a place available in a local care home, or a person's house may need altered to help them get around.

Actions

An important solution to delayed discharge is better joint working between health and social care services. To ensure this we legislated, through the Public Bodies (Joint Working) (Scotland) Act 2014, to integrate local health and social care systems, with the key aim of improving people’s experience of health and care services and the outcomes that services achieve. Read more information about health and social care integration.

We continue to work with local partnerships to drive the development of innovative services that are aimed at caring for more people in the home, or a homely setting. Services like Intermediate Care have been proven to help reduce admissions to hospital and improve the discharge process by providing step-up, or step-down care within people’s homes, care homes or community hospitals. Read more information about intermediate care

Delayed discharge data

Delayed discharge monthly census

From June 2015 information on delayed discharges, including the reason for and length of delay, is published in a monthly census by NHS National Services Scotland's Information Services Division (ISD).

Bed days occupied by delayed discharges

Data on the number of bed days lost to delayed discharges  (the days between being 'ready for discharge' and the actual date of discharge) has been published by ISD since August 2012 and is used as an additional measure.

Bed days lost data covers the whole calendar month and includes bed days associated with delays that would not be captured in the snapshot census. From June 2015 bed days lost data is published monthly, alongside the monthly snapshot census.

For more information, see also our policy pages on hospital care and intermediate care.

Guidance

We produced the following practical guides for health and social care practitioners relating to discharge planning:

We produced a model framework for the production of joint hospital discharge protocols (CCD9/2003) in 2003 and a best practice template for Admission, Transfer and Discharge (ATD) protocol for use in NHS facilities in Scotland in 2012.  

Delayed Discharge Expert Group

In 2010 an Expert Group of health and social care professionals made a number of recommendations aimed at reducing the level of delayed discharges across Scotland. 

You can read the full report, and recommendations from July 2012 in our website archive.

Building on the Expert Group report, the Joint Improvement Team (now the iHub) identified the 10 actions partnerships should take to transform discharge. Each action linked to a range of tools that could support improvement.