Action to cut delayed discharge

National exercise to re-assess hospital patients who are clinically safe to be discharged

Patients who no longer need to be in hospital are to be reassessed as soon as possible to get them the right care in the right place at the right time.

Before the end of the month each health board area will identify patients who are clinically safe to be discharged without further delay and can safely move home or to another setting such as an interim placement in a care home.

Staying in hospital is not the best option for those who are clinically fit for discharge. Being in hospital for longer than needed is not in the best interests of the individual, particularly for older patients, reducing their ability to look after themselves and return home.

This approach is based on good practice already adopted by several health boards. Patients will only be discharged if it is deemed safe, and clinical risk assessments will take into account the capacity of social care and social work and the potential impact on families or carers of patients.

This is the latest step in efforts to free up capacity in hospitals and help get the NHS through the toughest winter in its history. It builds on last week’s £8 million commitment to provide an extra 300 interim care home beds to get patients discharged quicker.

Health Secretary Humza Yousaf said: “First and foremost, we know hospital is not a good place to be for people who are medically fit to leave, because it can lead to them becoming weaker or less independent. That’s why it’s so important they can move home, or to a homely setting, as soon as possible.

“We believe this will also help to alleviate pressure on our NHS by freeing up beds and improving the flow of patients through hospitals. It is also, crucially, in the best interest of the people concerned.

“If we can reduce delayed discharge there is more chance that beds will be available for people who need them. We hope that these reviews will also contribute to reducing some of the pressures our hospitals are facing.”

Additional Winter support for NHS

Delayed Discharge in NHS Lothian returns to pre Covid-19 levels

The number of days that patients who have been delayed from leaving hospital because of no appropriate place to go to has risen to 7,829 for July 2021, the latest month statistics are available for.

This is an increase of 2,004 from 5,825 delays throughout June and triple the number of bed days occupied from delayed discharge at the start of the Covid-19 pandemic when 2,531 delays occurred.

At the start of the Covid-19 pandemic SNP Ministers made the decision to move hospital patients into care homes, to free up hospital space for dealing with the Covid-19 pandemic. It later emerged that patients being moved from hospitals to care homes where not tested for Covid-19 leading to higher rates of Covid-19 deaths in care homes than anywhere else in Scotland.

The level of delayed discharge in NHS Lothian has now returned to pre- pandemic levels with the number of bed days in hospital for delayed discharge being 11 higher than March 2020, 7,278, when hospital patients where moved to care homes.

Edinburgh and the Lothians were in the process of recovering from a Social Care crisis before the pandemic hit, with the peak of delayed discharge in hospitals being in October 2018, when 11,855 combined days when patients were not able to leave hospital, despite being back to health.

Lothian MSP, Miles Briggs, said: “These figures are very concerning, with the number of patients being stuck in hospital without a suitable destination, returning to pre pandemic levels.

“In Edinburgh and the Lothians there has been a long standing challenge to provide social care, which started to shift towards care in the community.

“We are now seeing increasing numbers of patients not able to leave hospital and the Edinburgh Integrated Joint Board are planning on closing more care homes.

“Patients leaving hospital must have a suitable destination to go once recovered, so that we are not in a position where people are waiting days on end in hospital, when they don’t need to be there.”