Mental Health Inpatient Census Part 3: Hospital-Based Complex Clinical Care and Long Stay

Results from the Hospital Based Complex Clinical Care (HBCCC) and Long Stay Census, carried out in April 2024. The data was collected as part of the Inpatient Census.


Number of HBCCC and Long Stay Patients in Census

In the 2024 census, a total of 1,313 patients were classified as Hospital Based Complex Clinical Care (HBCCC) or Long Stay patients. 542 (41%) were receiving HBCCC, and 771 (59%) were Long Stay patients. Long Stay refers to patients in the hospital for at least 6 months with no delayed discharge date but not receiving HBCCC.

Of these 1,313 patients, 1,084 (83%) were in Mental Health, Learning Disability, or Addiction Inpatient Beds in NHS Scotland facilities. 98 (7%) were in General Acute / Community Hospital NHS Scotland facilities. 131 (10%) were treated outwith but funded by NHS Scotland (e.g., private hospitals or non-NHS Scotland UK facilities). There are also a very small number of patients treated within NHS Scotland but funded externally.

Please note: The numbers provided in this publication for HBCCC patients may not match those in the Mental Health Inpatient Census parts 1 & 2. This is because in Parts 1 & 2, only HBCCC patients with mental health diagnoses are considered. In Part 3, all HBCCC patients are included in the figures.

Table 1: Number of HBCCC and Long Stay patients by census part, 2023 – 2024

Mental Health Inpatient Census and HBCCC Census, NHS Scotland 2023-2024.

Inpatient Census All Patients HBCCC Patients Long Stay Patients

 

2023

2024

2023

2024

2023

2024

Part 1: Mental Health Bed Census

1,066

1,084

508

447

558

637

Part 2: Outwith NHS Scotland Placements

120

131

50

70

70

61

Part 3: HBCCC & Long Stay

137

98

79

25

58

73

All HBCCC patients in Inpatient Census

1,323

1,313

637

542

686

771

Age and sex

Figure 2 shows the age and sex breakdown of patients receiving HBCCC at the 2024 census. 224 (41%) were female and 317 (59%) were male. A majority of HBCCC patients, 327 (60%), were aged 65+.

Figure 2: Number of HBCCC patients by age group and sex

Mental Health Inpatient Census and HBCCC Census, NHS Scotland 2024.

Figure 2: There were 155 female and 172 male HBCCC patients aged 65 and over, 38 female and 90 male HBCCC patients aged between 40 and 64 and 31 female and 55 male HBCCC patients aged between 0 and 39.

Figure 3 shows the age and sex breakdown of Long Stay patients at the 2024 census. Some key points include:

  • 483 (63%) were male, and 288 (37%) Long Stay patients were female.
  • The largest age category of Long Stay patients, 324 (42%), were aged 40-64.
  • 207 (27%) Long Stay patients were aged 65 or over, and 240 (31%) were under 40.

Figure 3: Number of Long Stay patients by age group and sex

Mental Health Inpatient Census and HBCCC Census, NHS Scotland 2024.

Figure 3: Males make up the majority of LS patients. There were 90 female and 117 male LS patients aged 65 and over, 121 female and 203 male LS patients aged between 40 and 64, and 77 female and 163 male LS patients aged between 0 and 39.

Ethnicity

At the 2024 census, most HBCCC or Long Stay patients described themselves as White Scottish (74%). An additional 6% described themselves as White, while 8% described themselves as White Other British.

Figure 4: Number of patients by ethnicity

Mental Health Inpatient Census and HBCCC Census, NHS Scotland 2024.

Figure 4: HBCCC or LS patients are overwhelmingly of White Scottish ethnicity (880 patients) where reported. The HBCCC or LS patients who were of another White ethnicity included mostly White Other British patients (93), there were also 11 patients who described themselves as being of African, African Scottish or African British ethnicity.

*Data was missing or “prefer not to say” for 72 patients.

** Numbers less than 5 have been suppressed to protect data confidentiality

Consultant Specialty

For the 542 HBCCC patients at the census, 263 (49%) had a consultant in Psychiatry of Old Age, 74 (14%) in General Psychiatry, and 70 (13%) in Forensic Psychiatry.

Figure 5: Number of HBCCC patients by current specialty 

Mental Health Inpatient Census and HBCCC Census, NHS Scotland 2024.

Figure 5: The largest group of HBCCC patients are treated in Psychiatry of Old Age specialties (263). There were also 74 HBCCC patients who had a consultant that was from General Psychiatry, 70 patients outwith NHS Scotland, 70 patients who had a consultant that specialised in forensic psychiatry medicine, and 20 patients in Geriatric Medicine, 20 patients were in other.

*Other includes a range of specialties with small numbers of patients that have been aggregated to protect patient confidentiality.

For the 771 Long Stay patients at the census, 303 (39%) had a consultant in General Psychiatry, 167 (22%) in Forensic Psychiatry, and 120 (16%) in Psychiatry of Old Age.

Figure 6: Number of Long Stay patients by current consultant specialty 

Mental Health Inpatient Census and HBCCC Census, NHS Scotland 2024.

Figure 6: The largest group of LS patients are treated in Psychiatric specialties. There were also 61 LS patients who had a consultant that specialised outwith NHS Scotland, 30 patients had a consultant that specialised in learning disability, 31 patients in geriatric medicine, 10 patients in rehabilitation medicine and 34 patients in other.

*Other includes a range of specialties with small numbers of patients that have been aggregated to protect patient confidentiality.

NHS Board Breakdown

NHS Greater Glasgow & Clyde funded 29% of HBCCC patients, followed by NHS Lothian with 23%.

Figure 7: Number of HBCCC patients by NHS Board responsible for funding

Mental Health Inpatient Census and HBCCC Census, NHS Scotland 2024.

Figure 7: NHS Greater Glasgow & Clyde fund the largest number of HBCCC patients. NHS Lothian were responsible for funding the treatment of 122 HBCCC patients, NHS Fife funded the treatment of 73 HBCCC patients, NHS Tayside funded 56 patients, NHS Lanarkshire funded 44 patients,  NHS Grampian funded 34 patients, NHS Ayrshire & Arran funded 28 patients, NHS Highland and NHS Forth Valley funded 9 patients and ‘other’ funded 12 patients.

*Other includes Boards where numbers were too small to present individually.

** National Services Division is funded by the territorial NHS Boards, and provides funding for a small number of patients in cases where they may require more specialised, long-term or cost-intensive treatment.

NHS Fife had the highest rate of HBCCC patients at 19 per 100,000 population.

Figure 8: Number of HBCCC patients per 100,000 pop., by NHS board responsible for funding

Mental Health Inpatient Census and HBCCC Census, NHS Scotland 2024.

Figure 8: NHS Fife fund the highest rate of HBCCC patients per 100,000 population (19.5). NHS Tayside funded 13.4 per 100,000, NHS Lothian funded 13.3 per 100,000 population, NHS Greater Glasgow & Clyde 13.1 per 100,000, NHS Ayrshire & Arran 7.6 per 100,000, NHS Lanarkshire 6.6 per 100,000, NHS Grampian 5.8 per 100,000, NHS Borders 4.3 per 100,000 and NHS Forth Valley 2.9 per 100,000.

*Excludes Health Boards with numbers less than 10 to protect data confidentiality.

NHS Greater Glasgow & Clyde were responsible for the treatment of 216 Long Stay patients (28%). NHS Lothian had the next highest number of Long Stay patients with 147 (19%).

Figure 9: Number of Long Stay patients by NHS Board responsible for funding

Mental Health Inpatient Census and HBCCC Census, NHS Scotland 2024.

Figure 9: NHS Greater Glasgow & Clyde fund the largest number of LS patients at 216. NHS Lothian were responsible for funding the treatment of 147 LS patients, NHS Grampian funded 77 patients, NHS Lanarkshire funded 61 patients, NHS Highland funded 59 patients, NHS Fife funded 46 patients, NHS Tayside funded 42 patients, NHS Ayrshire & Arran funded 32 patients, NHS Dumfries and Galloway funded 31 patients, NHS Forth Valley funded 26 patients. 34 patients were funded by other health boards.

*Information was unknown for 1 patient

**Other includes Boards where numbers were too small to present individually

NHS Western Isles had the highest rate for Long Stay patients at 22.5 per 100,000 population. NHS Dumfries & Galloway had the next highest rate at 21 per 100,000 population.

Figure 10: Number of Long Stay patients per 100,000 pop by NHS Board responsible for funding

Mental Health Inpatient Census and HBCCC Census, NHS Scotland 2024.

Figure 10: NHS Western Isles fund the highest rate of LS patients per 100,000 population (22.5). NHS Dumfries & Galloway had a funding rate for LS patients at 20.8 per 100,000 population, NHS Greater Glasgow & Clyde 18.2 per 100,000, NHS Highland 18.2 per 100,000, NHS Lothian 16 per 100,000, NHS Borders 14.7 per 100,000, NHS Grampian 13.1 per 100,000, NHS 12.3 per 100,000 and NHS Tayside 10.1 per 100,000, NHS Lanarkshire 9.2 per 100,000, NHS Ayrshire & Arran 8.7 per 100,000 and NHS Forth Valley 8.5 per 100,000.

*Excludes Health Boards with numbers less than 10 to protect data confidentiality.

Local Authority Breakdown

Figure 11 and 12 provides analysis of patients in receipt of HBCCC and Long Stay patients by Local Authority of residence. This is based on the patient’s home postcode. City of Edinburgh had the most HBCCC patients at 17%. Glasgow City had the most Long Stay patients at 17%.

Figure 11: Number of HBCCC patients by Local Authority of home post code

Mental Health Inpatient Census and HBCCC Census, NHS Scotland 2024.

Figure 11: The City of Edinburgh has the largest number of HBCCC patients by home postcode (93). Fife had the second most with 63 patients. Renfrewshire had the third largest number of HBCCC patients by home postcode with 44, followed by Glasgow City with 41 patients. Perth & Kinross had 33 patients, North Lanarkshire had 26 patients and Inverclyde City had 20 patients. The remainder of areas had between 23 and 6 patients.

* Other includes Local Authorities where numbers were too small to present individually

** Information was unknown for 48 patients

Figure 12: Number of Long stay patients by Local Authority of home post code

Mental Health Inpatient Census and HBCCC Census, NHS Scotland 2024.

Figure 12: Glasgow City has the largest number of LS patients by home postcode (132). City of Edinburgh had the second largest number of LS patients by home postcode with 83 patients, followed by Highland and Aberdeen City with 48 patients. The remainder of areas had between 44 and 6 patients.

*Other includes Local Authorities where numbers were too small to present individually

** Information was unknown for 72 patients

Length of Stay

Average time in hospital for HBCCC patients was approximately 1 year and 4 months. For Long Stay patients, the average time in hospital was approximately 1 year and 6 months. The average stay of HBCCC patients was slightly shorter than in the 2023 census, while for Long Stay patients it was slightly longer. 

Table 2: Length of Stay, HBCCC and Long Stay patients.

Mental Health Inpatient Census and HBCCC Census, NHS Scotland 2024.

Length of stay

HBCCC Patients

Long Stay Patients

Less than 2 weeks

22

*

2 weeks to 1 month

22

*

1 to 3 months

59

*

3 to 6 months

53

*

6 months to 1 year

80

274

1 to 5 years

232

354

Over 5 years

74

143

Median (days)

485

546

*Long Stay inpatients have all been in hospital for more than 6 months.

Health Conditions

NHS Boards were asked to return information on any health conditions a patient had been diagnosed with. Mental Health conditions were the most prevalent for both HBCCC (62%) and Long Stay patients (75%) in the 2024 census.

Figure 13: Number of HBCCC patients by health condition

Mental Health Inpatient Census and HBCCC Census, NHS Scotland 2024.

Figure 13: Mental Health conditions are the most common diagnoses among HBCCC patients. 519 HBCCC patients had been diagnosed with a mental health condition, 5 HBCCC patients diagnosed with an Neoplasms, the rest collectively come to 18 diagnosis.

*Only includes most prevalent conditions

**Patients can have more than one condition

Figure 14: Number of Long Stay patients by health condition

Mental Health Inpatient Census and HBCCC Census, NHS Scotland 2024.

Figure 14: Mental Health conditions are the most common diagnoses among LS patients. 706 LS patients had been diagnosed with a mental health condition, 8 LS patients diagnosed with an abnormal clinical findings, 7 LS patients diagnosed with a circulatory condition, 6 LS patients diagnosed with an injury & poisoning, 5 HBCCC diagnosed with intestinal infectious disease, 39 LS were collectively diagnosed with in the other group.

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