Adults with Incapacity - delayed discharge: good practice guidance September 2023

5. Challenges

During this exercise we also heard of ongoing challenges that were being experienced across HSCPs.

“Local solicitors are taking too long to process legal aid applications.”

This was a common thread and was highlighted where families were applying for private guardianships. The legal aid process was described as cumbersome and time consuming and this delay contributed to the length of stay where the person was in hospital. Scottish Government officials are actively undertaking work to see what improvements can be made with this process.

“We have difficulty accessing psychiatrists to undertake assessments and to complete reports.”

This point was made by one of the more remote and rural areas where there were pressures in recruiting psychiatrists. The lack of adequate staff numbers was causing undue delays for people who were in hospital. We advised this particular area to escalate the matter within their Health Board area as a contributory issue to their delays.

“Local solicitors are slow in progressing private guardianship applications.”

This issue was raised in relation to progressing private guardianships. Staff advised that some private solicitors are unfamiliar with the AWI process and the need to work to timescales. This was often overlooked in terms of the person in hospital awaiting discharge. In response to this we advised of those areas who have an MHO linking with private solicitors to support them with the knowledge to progress the application to timescale. We also advised that we had heard from some areas where their own local authority area solicitors had informal discussions with private solicitors to guide them through the process. For those who had built good positive relationships with private solicitors this was not an issue.

“The Court process can be very slow.”

Some areas advised of delays with the Court process. We heard that some did not have established relationships with Sheriffs and so lacked confidence to approach them to try and resolve or understand the issue. In these situations SG can work with the HSCP and the courts to identify if any improvements to process can be made. Some areas did take the advantage of this offer of support.

“Our MHO capacity is difficult, and we are having difficulties recruiting.”

This was a common theme and one that was fully recognised by the team. In some areas MHOs are paid at a Senior Practitioner status given the complex and autonomous nature of the MHO role.

Some areas reported that, despite additional funding from the Scottish Government, they could not attract social workers to undertake MHO training given the workload commitments as well as their daily duties.

Other areas reported that they were able to recruit but this was often short lived as MHO’s would move to neighbouring authorities which offered the senior practitioner payment as recognition of the status and complexity of the role.

The ability to pay the higher rate is being explored as the National Social Work Agency framework progresses and this will involve the Office of the Chief Social Work Advisor working with COSLA and trade union partners in attempts to resolve the terms and conditions issue as well as making the role more attractive.