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.
Part of
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 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.
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.
*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.
*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.
*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.
*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.
*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.
*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.
*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.
* 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.
*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.
*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.