Mental Health Inpatient Census 2025 - Parts 1 and 2
Annual publication of data collected in the Inpatient Census covering patients in mental health, addiction and learning disability beds who are funded by NHS Scotland at a point in time.
Part Two
1. Outwith NHS Scotland placements
-
103 patients in the 2025 census were funded by NHS Scotland but receiving treatment outwith NHS Scotland.
- These patients had been in hospital for an average of 5 years, 9 months at the time of the census.
- 30 patients (29%) had a diagnosis of learning disability or autism.
Patients treated outwith NHS Scotland are patients with mental health, learning disability, or addiction diagnoses who are funded by NHS Scotland but treated elsewhere, for instance NHS England, private facilities, or local authority care.
Some patients with highly complex, specialist needs are treated outwith NHS Scotland facilities. It can be more cost-effective to send patients to facilities outwith NHS Scotland due to individual needs. Each care package is individually and carefully considered by Boards.
Table 1: Patients outwith NHS Scotland, by NHS Board funding.
Psychiatric, addiction or learning disability inpatients, funded by but treated outwith NHS Scotland, March/April census 2014 – 2025
|
NHS Board |
2014 |
2016 |
2017 |
2018 |
2019 |
2022 |
2023 |
2024 |
2025 |
|
National Services Division |
c |
c |
c |
c |
c |
c |
c |
0 |
c |
|
NHS Ayrshire & Arran |
34 |
29 |
c |
c |
c |
20 |
10 |
8 |
7 |
|
NHS Borders |
c |
c |
c |
27 |
c |
16 |
c |
11 |
11 |
|
NHS Dumfries & Galloway |
10 |
c |
c |
c |
c |
c |
6 |
5 |
10 |
|
NHS Fife |
c |
c |
c |
c |
c |
7 |
7 |
5 |
c |
|
NHS Forth Valley |
c |
c |
c |
c |
0 |
0 |
0 |
0 |
0 |
|
NHS Grampian |
18 |
14 |
14 |
15 |
16 |
20 |
20 |
17 |
16 |
|
NHS Greater Glasgow & Clyde |
11 |
c |
c |
c |
c |
c |
6 |
7 |
7 |
|
NHS Highland |
c |
10 |
c |
20 |
19 |
9 |
10 |
10 |
9 |
|
NHS Lanarkshire |
c |
10 |
14 |
15 |
15 |
43 |
40 |
38 |
10 |
|
NHS Lothian |
20 |
25 |
24 |
59 |
24 |
22 |
19 |
22 |
22 |
|
NHS Orkney Islands |
c |
c |
c |
c |
c |
c |
c |
c |
0 |
|
NHS Shetland |
c |
c |
c |
c |
0 |
0 |
0 |
0 |
0 |
|
NHS Tayside |
16 |
13 |
11 |
14 |
12 |
c |
0 |
c |
0 |
|
NHS Western Isles |
c |
12 |
c |
13 |
c |
8 |
0 |
6 |
c |
|
Not Known |
0 |
0 |
0 |
0 |
0 |
c |
c |
c |
0 |
|
All |
143 |
137 |
109 |
197 |
126 |
162 |
124 |
135 |
103 |
c - Suppressed due to small numbers
Reasons and locations for treatment
- 89 patients (86%) were treated in private facilities. 4 (4%) were treated in NHS England and 10 (10%) in other facilities, for instance care homes.
- 82% of patients were placed outwith NHS Scotland because there was no facility that could meet the patients’ needs within NHS Scotland, when there was no alternative to treatment
- 13% were placed outwith NHS Scotland because there were no available beds in an appropriate facility.
The majority of patients treated outwith NHS Scotland are treated in private facilities, while a smaller proportion are treated in NHS England and other facilities.
Figure 1: Locations of patients outwith NHS Scotland.
Psychiatric, addiction or learning disability inpatients, funded by but treated outwith NHS Scotland, March/April census 2014 - 2025
Patient demographics
In previous years, patients treated outwith NHS Scotland tended to be older on average than those treated in NHS Scotland facilities. However, in 2025 only 8% were over the age of 65. compared to 34% of patients treated within NHS Scotland. 44% of patients treated outwith NHS Scotland were aged under 40.
There were 62 male patients (60%) and 41 female patients (40%) treated outwith NHS Scotland at the 2025 census.
Figure 2: Patients treated outwith NHS Scotland by age or sex.
Psychiatric, addiction or learning disability inpatients, funded by but treated outwith NHS Scotland, 2025 census.
Length of stay
The average (median) length of stay for patients treated outwith NHS Scotland was 2,093 days (approximately 5 years and 9 months).
Table 2: Average (median) days since admission.
Psychiatric, addiction or learning disability inpatients, funded by but treated outwith NHS Scotland, March/April census 2014 – 2025.
|
Group |
Average (median) number of days since admission |
Approx. number of years / months |
|
Outwith NHS Scotland Patients |
2093 |
5 years, 9 months |
|
Within NHS Scotland Patients |
119 |
4 months |
Information on the length of time that has passed since the patients’ last care plan review was provided for 92 patients. Of these, 13 patients (13%) treated outwith NHS Scotland had their last care plan review less than two weeks prior to the 2025 census. 72 patients (78%) had their last care plan review within 6 months prior to the census.
Diagnoses and anticipated discharge
Of the 103 patients receiving treatment outwith NHS Scotland:
- 16% of patients were receiving Hospital-Based Complex Clinical Care.
- 45% were under forensic services
- 29% had a learning disability or autism
29 patients treated outwith NHS Scotland had a diagnosis of schizophrenia (28%), 27 patients (26%) had a diagnosis of a learning disability or autism, and 14 (14%) had a personality disorder diagnosis.
Figure 3: Number of patients with selected mental health conditions.
Psychiatric, addiction or learning disability inpatients, funded by but treated outwith NHS Scotland, 2025 census.
Where possible, data is provided on anticipated discharge/transfer and date of discharge/transfer. 14% of patients are anticipated to return to NHS Scotland within one year.
SIMD and Urban Rural classification
Of the 64 patients treated outwith NHS Scotland who had a valid postcode, 27 (42%) came from the most deprived 20% of areas and 7 (11%) from the least deprived.
34 (53%) were from Large Urban Areas, 34 from Other Urban Areas (28%), and 17 from Accessible Rural (27%).