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

Introduction

Hospital Based Complex Clinical Care (HBCCC) was introduced in Scotland on June 1, 2015, following a review of NHS Continuing Care.

This report provides an overview of the Hospital Based Complex Clinical Care census. This was conducted by the Scottish Government and NHS Boards as of April 10, 2024.

HBCCC patients are defined as those requiring long-term complex clinical care in a hospital setting. HBCCC patients cannot have their care needs met anywhere other than a hospital due to the complexity of their condition. This includes those within NHS Scotland facilities and non-NHS Scotland facilities funded by NHS Scotland.

Patients receiving HBCCC cannot be considered as delayed discharge. This is where patients continue occupying beds beyond their ready-for-discharge date.

Patients receiving Long Stay care are also included. A Long Stay patient is someone who has been in hospital for at least 6 months (without HBCCC and no ready-for-discharge date) as of the census date.

Changes in census definition

The census’s definition and scope changed in 2017 after the first HBCCC census in 2016.

Analysis in the 2024 census cannot be directly compared to the 2016 HBCCC analysis. Data from 2017 to 2024 can be compared more easily.

Census scope

The Mental Health Inpatient Census consists of three parts, covering different patient categories.

Part 1: Patients in psychiatric, addiction, or learning disability inpatient beds in NHS Scotland facilities.

Part 2: Patients funded by NHS Scotland but treated outwith NHS Scotland facilities.

Part 3: Patients receiving Hospital Based Complex Clinical Care (HBCCC) or Long Stay in general acute or community hospital inpatient beds.

Focus of the report

This report primarily focuses on Hospital Based Complex Clinical Care (HBCCC) patients and Long Stay patients.

Information is presented from Parts 1, 2, and 3 of the census, including those meeting the HBCCC definition and Long Stay patients.

This is the seventh year of HBCCC data collection.

Feedback-driven improvements 

After the 2016 report, users provided feedback requesting analysis for Long Stay patients. This change was implemented starting with the 2017 report and has continued in the 2024 report. 

Data validation and provisional figures

Extensive validation of underlying data has been carried out by NHS Boards and Scottish Government Statisticians. Figures presented in the report are provisional and may change in future publications.

Accompanying data

An accompanying spreadsheet with data and summary information at NHS Board level is available for reference.

Detailed analysis at hospital and ward levels can be accessed by staff in NHS Boards. Access is granted by a nominated NHS Board authoriser. For more details please contact MHIC@gov.scot.

Acknowledgements

We are extremely grateful to all those who assisted with the Inpatient Census, in particular, colleagues from the Health Boards, hospitals and care homes who provided information.

An Official Statistics Publication for Scotland

These statistics are official statistics. Official statistics are statistics that are produced by crown bodies, those acting on behalf of crown bodies, or those specified in statutory orders, as defined in the Statistics and Registration Service Act 2007.

Scottish Government statistics are regulated by the Office for Statistics Regulation (OSR). OSR sets the standards of trustworthiness, quality and value in the Code of Practice for Statistics that all producers of official statistics should adhere to.