A delayed discharge is a hospital patient who is clinically ready for discharge from inpatient hospital care but continues to occupy a hospital bed beyond the ready for medical discharge date. Delays can occur for a variety of reasons, but are usually due to a lack of appropriate care or services available within the community.
Older people may experience functional decline as early as 72 hours after admission and the risk increases with each day delayed in hospital. This increases the risk of harm and of a poor outcome for the individual and further increases the demand for institutional care or more intensive support at home.
Reducing the number of delayed discharges has been a key priority of the Scottish Government. Integrated Joint Boards are considered central to delivering this reduction.
In 2011 a target was introduced which aimed to ensure that no patient was unnecessarily delayed in hospital for longer than 2 weeks by April 2015.
From April 2016 as part of the new integration indicators there was a commitment to increase the percentage of people who are discharged from hospital within 72 hours of being ready for discharge.
The Scottish Government from 2015-16 to 2017-18 has invested £300m in an integrated care fund and £100m to reduce delayed discharges. In 2015-16 the Scottish Government allocated £30m to health boards for delayed discharge.
Approach - Survey to IJBs
The Committee issued a survey to all integrated authorities. This included various topics, including establishing how the additional allocation to tackle delayed discharges has been spent and what has been achieved with the funding. The responses can be read here:
Following analysis of survey responses a sample of integrated joint boards, local authorities and health boards provided oral evidence on 6 September 2016.
The Committe also received two individual submissions on delayed discharge:
On 5 October the Convener wrote to the Cabinet Secretary for Health and Sport outlining the Committee's findings.
On the 17 October the Cabinet Secretary for Health and Sport replied to the Covener.
On 19 October the Committee received a letter from East Ayrshire Health and Social Care Partnership in response to our letter to the Cabinet Secretary.
On 8 November the Convener wrote a follow-up letter to the Cabinet Secretary for Health and Sport on delayed discharges.
On 18 November the Cabinet Secretary for Health and Sport responded to the Convener's follow-up letter.