Delayed discharge
No one should stay in hospital longer than they need to. We want to reduce waiting times, help patients move through the system more smoothly, and provide more care in the community rather than in hospitals. Staying in hospital when you don't need to be there can affect your independence and slow down your recovery.
About delayed discharges
A delayed discharge happens when someone is ready to leave hospital but cannot do so. Once a patient’s clinical team have decided they are ready to go home or move to another care setting, that becomes their discharge date. If the patient is still in hospital after midnight on that date, they are counted as a delayed discharge.
There are many reasons this can happen, such as waiting for a care package or a place in a care home. Some cases are more complex, particularly those involving mental health, adults who lack the capacity to make decisions about their care, and people with learning disabilities or complex care needs.
Mental health, adults with incapacity, and learning disabilities
Mental health delays happen when someone who is well enough to leave an NHS mental health ward cannot do so for any reason. Adults with incapacity (AWI) are people who are ready to leave hospital but cannot make decisions about their ongoing care. Adults with incapacity cannot be discharged until the right legal protections are in place, which means these delays are often longer than others. Delays for people with learning disabilities and complex support needs also tend to last longer and can be harder to resolve.
What we measure
We count delayed discharges for adults aged 18 and over in NHS inpatient beds across Scotland. We collect information by NHS board, hospital, and specialty, as well as by the local authority where the person lives. We also break down the data by age, sex, and how long the delay has lasted.
Public Health Scotland (PHS) collects this information regularly from NHS Boards, using agreed definitions. Published statistics are on the PHS website.
The Dynamic Support Register (DSR) helps improve awareness of people with learning disabilities and complex care needs across Scotland. It covers adults aged 18 and over whose care is funded by a Local Authority or NHS Board. The aim is to prevent people with learning disabilities from staying in hospital longer than necessary, or being placed in care settings outside their local area that they and their family did not choose. It helps professionals provide the right level of care required. Published DSR statistics are on the PHS website.
What we are doing
Reducing delayed discharges needs joined-up action across health and social care.
The Health and Social Care Improving Flow Plan will build on the NHS Scotland Operational Improvement Plan (OIP) (2025) and set out a national approach to improving flow across health and social care. A key aim of the Plan is to reduce delays in discharge by helping people receive the right care, in the right place at the right time.
As part of this Plan, we are working to ease pressure on hospitals by improving how patients move through the system, reducing unnecessary delays and supporting timely discharge from hospital. This includes increasing the use of alternatives to hospital admission where appropriate, reducing avoidable admissions, starting discharge planning from the point of admission, reducing delays to investigations and developing services that enable tests and investigations to happen more quickly or remotely.
We are also helping local areas increase capacity in the community. This includes expanding home care support, community rehabilitation and reablement services, Hospital at Home, and step-down facilities that offer rehabilitation and longer assessment periods. These services help people stay independent, prevent their care needs from escalating, and support their health and wellbeing at home.
This work also connects with the Health and Social Care Service Renewal Framework (2025) and Scotland's Population Health Framework 2025 to 2035 (2025), together forming a whole-system approach to health and social care across Scotland.
Other actions we are taking include:
- commissioning Healthcare Improvement Scotland (HIS) to help local areas reduce mental health and AWI delays - see the resources section below for learning from this work
- publishing the Coming Home Action Plan (2026) jointly with COSLA, which reports on progress and recommends further steps.
Key legislation
Effective joint working between health and social care services is essential to reducing delayed discharges. The Public Bodies (Joint Working) (Scotland) Act 2014 brought together local health and social care systems, with the aim of improving people's experiences and outcomes.
The Adults with Incapacity (Scotland) Act 2000 protects people who have lost the capacity to make decisions. We are reforming this legislation to better support people's human rights. An expert working group and Ministerial oversight group have been leading this work since October 2025 and are expected to continue into early 2027. You can find more information in the overview of AWI legislation and what's changing.
Guidance and other resources
The following resources support improvements in patient flow and delayed discharge:
- Adults with Incapacity – delayed discharge: good practice guidance (September 2023) - a collection of good practice on AWI delayed discharges
- Reducing Adult with Incapacity delayed discharge from hospital - outputs from Healthcare Improvement Scotland's work with Glasgow City, Dumfries and Galloway, and Forth Valley
- Reducing delayed discharges in mental health and learning disability services in NHS Grampian - learning from work with NHS Grampian at the Royal Cornhill Hospital
- Delayed Discharge Improvement Work – Healthcare Improvement Scotland - information on ongoing work to reduce delayed discharges for people with mental health needs, learning disabilities, and AWI across Scotland
- Scottish Approach to Change – supports the healthcare system to do change well
- Learning from Dundee - lessons from initiatives supporting older people and the effect on delayed discharge
- Empathy maps - a simple visual tool to help understand what a person thinks, does, and feels when using a service
- Coming Home training guidance - describes the training that social care staff and community integrated teams need to support people to live in their local communities
Health and Social Care Scotland also hosts a range of publications on their resources page. This includes guidance on discharge planning for adults with incapacity, involving carers in discharge planning, and the impact of the Adults with Incapacity (Scotland) Act 2000 on delayed discharge.
The Mental Welfare Commission also produces good practice guidance on mental health and incapacity law. Best practice on discharge without delay and optimising flow is available on Turas, and Housing Options Scotland has a range of resources available.