Information Services A Division of NHS National Services Scotland
Patients Ready for Discharge in NHSScotland figures from July 2006 census
Contents Page
Introduction and background………………………………………………………………………….. 2
Summary of Key Points……………………………………………………………………………….. 4
Commentary……………………………………………………………………………………………. 6
Tables
1 Numbers, median and mean duration; by principal reason…………………. 9 2 Numbers by NHS Board area of treatment and principal reason…………… 10 3 Numbers by Local Authority Partner and principal reason…………………… 14 4 Numbers by NHS Board area of treatment and duration of delay…………… 18
Charts
1 Numbers by Principal Reason and census…………………………………….. 8 2 Numbers by duration (weeks)…………………………………………………… 20 3 Numbers by Specialty group…………………………………………………….. 20 4 Numbers by Age Group and Principal Reason………………………………… 21 5 Numbers by Principal Reason and duration of delay………………………….. 21
Appendices 1 Basic Approach……………………………………………………………………………… 22 2 Definitions & Terms…………………………………………………………………………. 23 3 Data Quality………………………………………………………………………………….. 25 4 Census Dates………………………………………………………………………………… 26 5 Supplementary Items………………………………………………………………………. 27 6 Effect of change in definition 29
Acknowledgements…………………………………………………………………………………….. 30 Future publication and further information…………………………………………………………… 30
This is an ISD Scotland National Statistics release
http://www.isdscotland.org/delayed_discharges
health briefing number 06/03 issued August 2006 For further information please contact Caroll Brown 0131 275 6099
Patients Ready for Discharge in NHSScotland This is an ISD Scotland figures from July 2006 census National Statistics release. Introduction and background
About this report
This publication summarises the results of patients ready for discharge from a “snapshot” of NHS inpatients as at the July 2006 census. There have been some changes in the definition, and recording of the data, which has resulted in changes to the presentation of this report. These changes are detailed below.
Note also that delayed discharges for the old Argyll and Clyde Health Board are now shown in two parts headed Argyll (NHS Highland) and Clyde (NHS Greater Glasgow). It is planned that this will continue until the April 2007 report.
ISD Scotland, in conjunction with the Scottish Executive and health and local authority partners at local level, has been reviewing the definition of what constitutes a ‘delayed discharge’. We have also been assessing how best to present this census data. All of the changes outlined below have been the subject of a wide- ranging consultation and have been agreed by the National Advisory Group on Delayed Discharges Information. In some instances the revisions have been made to reflect the introduction of revised Scottish Executive targets. Patients delayed due to awaiting place/bed availability in a specialist residential facility where no facilities exist (codes 24DX, 24EX and 42X), or due to requirements of the Adults with Incapacity Act (code 51X) are already reported separately. These patients will continue to be reported separately; but will now be categorised under ‘Complex Needs’ (code 9). These codes will now operate as secondary reason codes to ‘Complex Needs’. From July 2006, cases where partnerships are unable, for reasons beyond their control, to secure a patient’s safe, timely and appropriate discharge from hospital will also be shown under the category ‘Complex Needs’ but with no secondary code. These cases were previously included in the census totals but are now reported separately, at the time of the July 2006 census there were 5 in total. Directors of Social Work, NHS Board Chief Executives or their nominated representatives have reported these cases formally to ISD and the Scottish Executive. All Complex Needs cases are reported separately as a supplement to this report [see Appendix 5].
Effect of the changes
From the July 2006 census patients whose ‘clinical readiness for discharge’ has only been ascertained within the 3 working days or less preceding the census date have been omitted from the census totals, these patients are now categorised as ‘Zero delay’ cases. At the time of the July 2006 census this affects 116 cases.
From the July 2006 census patients who have a planned discharge and an agreed discharge date within 3 working days of the census have been omitted from the census totals. At the time of the July 2006 census this affects 51 cases of which 22 were over 6 weeks.
Principal reason code 33 (change in patients health circumstances i.e. patient too ill at the time of the census to be discharged) was previously reported on separately in the report. From the July 2006 census the definition of a delayed discharge has been amended to exclude such cases and census reports are being adjusted accordingly. Based on the four quarterly Census reports for the period July ’05 to April ’06, the average number of patients being reported on separately due to a change in health circumstances was 20. This change has no effect on the numbers of delayed discharges reported in the main report.
Patients Ready for Discharge in NHSScotland figures from July 2006 census page 2
About patients ready for discharge
For most patients, following completion of health and social care assessments, the necessary care, support and accommodation arrangements are put in place in the community without any delay in the patient’s safe and appropriate discharge from hospital.
A delayed discharge occurs when a patient, clinically ready for discharge, cannot leave the hospital because the other necessary care, support or accommodation for them is not readily accessible and/or funding is not available, to purchase a care home place, for example.
‘Patients Ready for Discharge’ data has been collected nationally since September 2000 according to national standard definitions and data recording criteria laid out in Management Executive Letter (MEL)(2000)07. issued in February 2000 by the Scottish Executive Health Department (SEHD).
The national definitions allow for a consistent approach to a patient being considered ‘ready for discharge’ i.e. the patient is clinically ready to move on to the next stage of care. For most Local Authority Partners there is an accepted period beyond the clinically ready for discharge date during which all assessment and follow-on arrangements are put in place. The common period for local discharge planning is six weeks. From the April 2004 census the report focuses mainly on those patients who have been ready for discharge for more than six weeks at the time of the census [see Appendix 2].
A separate report has been produced showing information at Local Authority Partner level.
Patients Ready for Discharge in NHSScotland figures from July 2006 census page 3
This is an ISD Scotland National Statistics release. Summary of Key Points Note that changes have been made to the definition of patients ready for discharge. It has not been possible to identify the effect of these definitional changes retrospectively, so the comparisons below are with figures previously published, and may therefore in some instances overstate reductions or understate increases. [For further information see the introduction to this report and Appendix 6]. • The number of patients ready for discharge in Scotland who had been ready for discharge for over six weeks at the time of the July 2006 census has increased from the April 2006 census. There were 627 cases at the July 2006 census compared with 498 at the April 2006 census, and 753 at the July 2005 census.
• At the July 2006 census, there were a total of 1,243 patients ready for discharge in Scotland, compared with 1,046 at the April 2006 census, and 1,465 at the July 2005 census.
• The number of patients delayed for one year or more has decreased from the April 2006 census. There were 17 cases at the July 2006 census, compared with 19 at the April 2006 census, and 15 at the July 2005 census.
• The median duration to the census point for all patients ready for discharge was 43 days (39 days at the April 2006 census, and 44 days at the July 2005 census), while the mean duration was 71 days (69 days at the April 2006 census, and 70 days at the July 2005 census).
• Of the number of patients ready for discharge for more than six weeks 75% were 75 years of age and over.
• The number of patients ready for discharge at any point in time can be viewed as part of a dynamic process of discharge planning. For example, it is estimated that 64.5% of those patients who had a duration of six weeks or more (the common discharge planning period) at the April 2006 census had been discharged by the July 2006 census.
The table below presents numbers of patients ready for discharge by reasons for delay*: -
April 2006 census July 2006 census
Reason for Delay (by group) No. outwith Total No. outwith Total six weeks six weeks Community Care Assessment reasons 70 339 71 350 Patients waiting to go home 54 111 66 135 Awaiting funding for a care home placement 69 104 62 101 Awaiting place availability in a care home/specialist 220 340 330 483 residential facility Healthcare Assessment/Arrangements 8 48 15 57 Patient exercising statutory right of choice** 46 62 38 52 Legal/Financial 15 19 22 28 Other*** 16 23 23 37
*The reason for delay is the patients’ reason for delay as at the census point.
**Where principal reason is ‘patient exercising statutory right of choice’, a secondary reason is recorded indicating the destination over which the right of choice is being exercised (e.g. awaiting nursing home place availability).
***Other includes Disagreements; Other patient/carer/family related reasons excluding patient exercising statutory right of choice; Community Care Arrangements (no additional detail); awaiting completion of social care arrangements (no additional detail); Principal reason not agreed; and Principal reason not recorded.
Patients Ready for Discharge in NHSScotland figures from July 2006 census page 4
This is an ISD Scotland National Statistics release.
• 12 NHS Boards reported an increase in the number of patients ready for discharge outwith the six week discharge planning period between April 2006 and July 2006. 2 NHS Boards reported a decrease and 1 NHS Board reported no change. [See Table 2]. Note that for the purpose of this comparison we have used the NHS board structure as reported at April 2006.
• 23 Local Authority Partners have shown an increase between April 2006 and July 2006 in the number of patients ready for discharge outwith the six week discharge planning period who were considered to have social work involvement. 8 Local Authority Partners have shown a decrease and one Local Authority Partner has reported no change. The overall number of patients ready for discharge outwith the six week discharge planning period who were considered to have social work involvement in the discharge planning process has increased (612 at the July 2006 census compared with 490 at the April 2006 census). [See Table 3].
• The number of patients outwith the six week discharge planning period in the Community Care Assessment reason category has increased slightly (71 at the July 2006 census compared with 70 at the April 2006 census).
• The number of patients outwith the six week discharge planning period who were waiting to go home has increased (66 at the July 2006 census compared with 54 at the April 2006 census).
• The number of patients outwith the six week discharge planning period who were awaiting funding for a care home placement has decreased slightly (62 at the July 2006 census compared with 69 at the April 2006 census).
• The number of patients outwith the six week discharge planning period who were awaiting place availability for a care home/specialist residential facility placement has increased considerably (330 at the July 2006 census compared with 220 at the April 2006 census).
• The number of patients outwith the six week discharge planning period who were in the Healthcare Assessment/Arrangements reason categories has increased (15 at the July 2006 census compared with 8 at the April 2006 census).
• The number of patients outwith the six week discharge planning period who were exercising statutory right of choice has decreased (38 at July 2006 census compared with 46 at the April 2006 census).
• The number of patients outwith the six week discharge planning period in the Legal/Financial reason categories has increased (22 at the July 2006 census compared with 15 at the April 2006 census).
• The number of patients outwith the six week discharge planning period in the Disagreements reasons has increased (17 at the July 2006 census compared with 11 at the April 2006 census).
Patients Ready for Discharge in NHSScotland figures from July 2006 census page 5
Commentary
General
The information on patients ready for discharge contained in this report is derived from a series of quarterly censuses and should be interpreted with care. As described in the introduction all ‘ready for discharge’ arrangements across Scotland reflect a variety of local factors, including local joint care agency discharge planning agreements. These factors should always be taken into account when making statistical comparisons.
The State Hospital data has been excluded from all analyses, as the special circumstances attached to the patient group make the data distinct from the rest of Scotland.
Note that changes have been made to the definition of patients ready for discharge. It has not been possible to identify the effect of these definitional changes retrospectively, so the comparisons below are with figures previously published, and may therefore in some instances overstate reductions or understate increases. [For further information see the introduction to this report and Appendix 6].
Table 1 Numbers, median and mean duration by principal reason
The “reason” information shown represents the principal reason in each case on the census date. It is important to note that duration of delay is calculated from the point patients are considered clinically “ready for discharge” (and not, for example from day 43 i.e. after a duration of delay of more than 6 weeks).
Principal reason can change over time, and as a consequence each duration shown may not be wholly attributable to the reason against which it appears. For example, ‘awaiting assessment’ may be the first identified principal reason for a patient then, subsequently, the principal reason may change to become awaiting the finalisation of the safe discharge arrangements.
Noteworthy points from Table 1 are covered in the ‘Summary of Key Points’.
Table 2 Numbers by NHS Board area of treatment and principal reason
For those patients who have been ready for discharge outwith the six week discharge planning period most NHS Board areas have “Community Care Arrangements” as the most common reason category except for NHS Highland which has “Other Patient/carer/family related” reasons as the most common reason category. The frequency of individual reasons within the categories varies markedly between NHS Board areas.
Overall the number of patients outwith the six week discharge planning period who were exercising their statutory right of choice has shown a decrease (38 at the July 2006 census compared with 46 at the April 2006 census). The largest decrease was in NHS Borders with no cases at the July 2006 census compared with 9 at the April 2006 census.
The number of patients exercising their statutory right of choice who were outwith the six week discharge planning period in NHS Highland increased from no cases at the April 2006 census to 6 cases at the July 2006 census, and NHS Ayrshire & Arran increased from 11 cases at the April 2006 census to 15 cases at the July 2006 census.
For 32 (84.2%) of those outwith the six week discharge planning period who were exercising their statutory right of choice, the destination over which right of choice was being exercised was care home placement (41 (89.1%) at the April 2006 census and 69 (83.1%) at the July 2005 census).
Patients Ready for Discharge in NHSScotland figures from July 2006 census page 6
This is an ISD Scotland National Statistics release.
Table 3 Numbers by Local Authority Partner and principal reason
The total number of patients ready for discharge outwith the six week discharge planning period is based on those resident in each Local Authority Partner area. Not all of these patients will have Social Work involvement in their discharge planning, or in their post-hospital care arrangements. A patient ready for discharge is not considered to have social work involvement in their discharge planning process if the principal reason for delay is in the Healthcare groups.
612 patients who had been ready for discharge for over six weeks were considered to have Social Work involvement in their discharge planning process at the July 2006 census, compared with 490 at the April 2006 census and 728 at the July 2005 census.
For those patients outwith the six week discharge planning period “Community Care Arrangements” is the most common reason category in all Local Authority Partner areas except East Ayrshire and Highland which both have “Other patient/carer/family related reasons” as the most common reason category. West Lothian has “Disagreements” as the most common reason category. The number of cases outwith the six week discharge planning period with social work involvement where the Local Authority Partner was not identified was 0 at the July 2006 and 1 at the April 2006 census (there were 2 cases at the July 2005 census).
Table 4 Numbers by NHS Board area of treatment and by duration
It is important to note for most patients, any delay in discharge is of a relatively short duration, such patients are therefore unlikely to appear in quarterly census figures.
The varied distribution of durations may be influenced by specialty and case mix differences, differences in local discharge planning agreements and the availability of local care facilities (care home places etc). Comparisons should be made against this background.
There has been a slight decrease in the number of patients who had been delayed for over a year. There were 17 cases at the July 2006 census compared with 19 at the April 2006 census (there were 15 cases at the July 2005 census).
The largest proportional increase was in the number of patients with duration of delay of 3-5 months. There were 249 cases at the July 2006 census compared with 187 at the April 2006 census (there were 276 at the July 2005 census).
Patients Ready for Discharge in NHSScotland figures from July 2006 census page 7
This is an ISD Scotland Chart 1 National Statistics release. Patients ready for discharge who are outwith the six week discharge planning period by principal reason for delay: Scotland; September 2000 to July 2006 There has been a considerable decrease in the number of patients waiting outwith the six week discharge planning period over the last four years. The October 2001 census shows the point where the figures were at their highest, there were 2,162 patients delayed outwith the six week discharge planning period. At the July 2006 census there were 6271 patients delayed outwith the six week discharge planning period, a reduction of 70.9% since the peak.
At most censuses the most commonly reported reason for delay for those outwith the six week discharge planning period is that the patient is awaiting place availability in a care home/specialist residential facility placement.
At the July 2006 census 52.6% of all cases outwith the six week discharge planning period were awaiting place availability for a care home/specialist residential facility placement. 11.3% were delayed due to Community Care Assessment reasons; 10.5% were waiting to go home; 9.9% were awaiting funding to purchase a care home place; 6.1% were exercising statutory right of choice; 3.7% were delayed due to other reasons, 3.5% were delayed due to Legal/Financial reason and 2.4% were delayed due to Healthcare reasons.
2500
2000
1500
Other
Legal/Financial
Number of patients 1000
Patient exercising statutory right of choice
Healthcare 500 Assessment/Arrangements Awaiting place availability in a care home
Awaiting funding for a care home placement 0 Patients waiting to go home Sep Jan Apr July Oct Jan Apr July Oct Jan Apr July Oct Jan Apr July Oct Jan Apr July Oct Jan Apr July 2000 2001 2001 2001 2001 2002 2002 2002 2002 2003 2003 2003 2003 2004 2004 2004 2004 2005 2005 2005 2005 2006 2006 2006 Census Community Care Assessment reasons
Other includes Disagreements; Other patient/carer/family related reasons excluding patient exercising statutory right of choice; Community Care Arrangements (no additional detail); awaiting completion of social care arrangements (no additional detail); Principal reason not agreed; and Principal reason not recorded.
The reason codes 24DX, 24EX and 42X (awaiting place or bed availability where no appropriate facilities exist) now act as secondary codes to Complex Needs [See introduction to this report and appendix 5]. Prior to the April 2003 census these codes were included under codes 24D, 24E and 42 (awaiting place or bed availability). Therefore cannot be taken out of the census totals prior to April 2003 census.
The reason code 51X (Adults with Incapacity Act) now acts as a secondary code to Complex Needs [See introduction to the July 2006 report and appendix 5]. Prior to the July 2004 census these codes were included under code 51 (legal issues). Therefore cannot be taken out of the census totals prior to July 2004 census.
1 Prior to the revision of the definition, the total would have been 649.
Patients Ready for Discharge in NHSScotland page 8 figures from July 2006 census Table 1 This is an ISD Scotland National Statistics NHS - Patients ready for discharge - Scotland release. Numbers, median and mean duration by principal reason; % of total duration; % of total; as at July 2006 census Patients ready for discharge Number outwith the Median Mean six week 2 % of total % of total Principal Reason Total Duration Duration 4 5 discharge 3 3 Duration number planning (days) (days) period1
All reasons 627 1243 43 71 100.0 100.0
Community Care Assessment 71 350 22 33 13.1 28.2 6 Community Care Assessment (no additional detail) ------7 awaiting commencement of post-hospital social care assessment 6 65 15 22 1.6 5.2 7 awaiting completion of post-hospital social care assessment 57 271 23 34 10.2 21.8 post-hospital social care assessment completed: awaiting agreement of senior social work practitioner 8 14 46 79 1.2 1.1 disagreement about social care recommendations between social work and health services ------
Community Care Arrangements 458 720 62 88 71.5 57.9 6 Community Care Arrangements (no additional detail) ------awaiting re-start services to discharge home - 2 || || 0.0 0.2 awaiting new services to discharge home 13 44 25 41 2.0 3.5 non-availability of public funding to purchase Residential/Nursing Home Place (no additional detail): ------Residential Home place 14 22 64 73 1.8 1.8 Nursing Home place 48 79 51 68 6.0 6.4 awaiting place availability (no additional detail): 2 6 || || 0.3 0.5 in Local Authority Residential Home 36 50 76 97 5.4 4.0 in Independent Residential Home 29 49 45 79 4.3 3.9 in Nursing Home (not NHS funded) 208 318 63 92 33.0 25.6 in Specialist Residential Facility for younger age groups (<65) 24 28 148 183 5.8 2.3 in Specialist Residential Facility for older age groups (65+) 15 15 121 127 2.2 1.2 awaiting completion of social care arrangements (no additional detail): - 1 || || 0.0 0.1 Local Authority Residential Home placement 2 2 || || 0.4 0.2 Independent Residential Home placement 12 13 131 124 1.8 1.0 Nursing Home placement (not NHS funded) 2 2 || || 0.5 0.2 In order to live in their own home - awaiting social support (eg carer) 16 28 45 86 2.7 2.3 In order to live in their own home - awaiting procurement/delivery of equipment/adaptations fitted 8 18 33 73 1.5 1.4 Specialist Housing provision 29 43 61 77 3.7 3.5
Healthcare Assessment 2 7 15 69 0.5 0.6 6 Healthcare Assessment (no additional detail) ------awaiting commencement/completion of post-hospital healthcare assessment 1 5 || || 0.3 0.4 disagreement about healthcare recommendations between social work and health services 1 2 || || 0.3 0.2
Healthcare Arrangements 13 50 32 40 2.3 4.0 6 Healthcare Arrangements (no additional detail) ------awaiting completion of healthcare arrangements (incl. awaiting equipment supplied by health only) 1 1 || || 0.1 0.1 awaiting bed availability in other NHS hospital/specialty/facility 12 48 32 41 2.2 3.9 awaiting bed availability in non-NHS facility (eg hospice) ------awaiting availability of transport ------awaiting routine discharge - 1 || || 0.0 0.1
Legal/Financial 22 28 81 116 3.7 2.3 6 Legal Financial (no additional detail) ------legal issues (including intervention by patient’s lawyer) 3 6 || || 0.4 0.5 financial and personal assets problem 19 22 91 130 3.2 1.8
Disagreements 17 25 72 89 2.5 2.0 6 Disagreements (no additional detail) - 1 || || 0.0 0.1 internal family dispute issues 2 3 || || 0.2 0.2 disagreement between patient/carer and health services 5 6 || || 0.9 0.5 disagreement between patient/carer and social work services 3 4 || || 0.3 0.3 disagreement between family and health services 2 4 || || 0.3 0.3 disagreement between family and social work services 5 7 || || 0.8 0.6
Other patient/carer/family related reasons 44 63 62 91 6.4 5.1 6 Other (no additional detail) 1 1 || || 0.1 0.1 patient exercising statutory right of choice 38 52 62 92 5.4 4.2 patient does not qualify for care ------family/relatives arranging care 2 3 || || 0.5 0.2 other patient/carer/family-related reason 3 7 || || 0.5 0.6
Principal reason not agreed ------
Reason not recorded -- - - xx x. not applicable. || not shown (less than 10 cases). 1. Number of patients ready for discharge with a duration of over 6 weeks (43 days or more), ie the common period for discharge planning agreement timescales across Scotland. 2. Total number of patients ready for discharge, in all specialties, reported as at July 2006 census. 3. Calculated on the number of cases where a ready for discharge date was recorded. Duration calculated from Ready for Discharge Date to July 2006 census date. 4. Duration expressed as a percentage of total cumulative duration. (Excludes the number where Ready for Discharge Date was not recorded). 5. Number of patients ready for discharge expressed as a percentage of the total number. 6. On a number of occasions the reason was recorded to category level only. 7. From the July 2006 census code 11 has been split to reflect whether the assessment was awaiting commencement (11A) or completion (11B).
Patients Ready for Discharge in NHSScotland page 9 figures from July 2006 census Table 2 This is an ISD Scotland National Statistics NHS - Patients ready for discharge release. Numbers by NHS board area of treatment and principal reason; as at July 2006 census
Patients ready for discharge
NHS Board area of treatment3 Number Argyll (NHS Clyde (NHS Greater Ayrshire & Arran Borders Dumfries & Galloway Principal Reason Highland) Glasgow) outwith the Total2 six week discharge No. No. No. No. No. No. No. No. No. No. planning within outwith within outwith within outwith within outwith within outwith 4 4 period1 6wks 6wks1 6wks 6wks1 6wks 6wks 6wks 6wks 6wks 6wks [see next page for other NHS Boards]
All reasons 627 1243 17 64 46 58 53 73 12 16 5 1
Community Care Assessment 71 350 5 15 18 7 38 10 5 5 1 - Community Care Assessment (no additional detail)5 ------awaiting commencement of post-hospital social care assessment 6 6 65 - 1 2 - 4 - 1 1 - - awaiting completion of post-hospital social care assessment6 57 271 5 14 14 6 31 74 31 - post-hospital social care assessment completed: awaiting agreement of senior Social work practitioner 8 14 - - 2 1 3 3-1- - disagreement about social care recommendations between social work and health services ------
Community Care Arrangements 461 723 12 40 22 43 9 38 6 10 1 1 Community Care Arrangements (no additional detail) 5 ------awaiting re-start services to discharge home - 2 - -1 -1 - - - - - awaiting new services to discharge home 13 443-1---2-11 non-availability of public funding to purchase Resid'l/Nursing Home Place (no add'l detail): ------Residential Home place 14 22 2 1 1 - - 5 - - - - Nursing Home place 48 79 - - 8 12 2 11 - - - - awaiting place availability (no additional detail): 2 6------41- - in Local Authority Residential Home 36 50-4-2- --1- - in Independent Residential Home 29 4936-214- -- - in Nursing Home (not NHS funded) 208 318 1 8 9 21 5 16 - 4 - - in Specialist Residential Facility for younger age groups (<65) 24 28------in Specialist Residential Facility for older age groups (65+) 15 15---1---3- - awaiting completion of social care arrangements (no additional detail): - 1------Local Authority Residential Home placement 2 2-2------Independent Residential Home placement 12 13-11------Nursing Home placement (not NHS funded) 2 2-2------In order to live in their own home - awaiting social support (eg carer) 16 2835-2------In order to live in their own home - awaiting procurement/delivery of equipment/adaptations fitted 8 18-111------Specialist Housing provision 29 43 - - 1 2 - 2 - 1 - -
Healthcare Assessment 27---11---- - Healthcare Assessment (no additional detail)5 ------awaiting commencement/completion of post-hospital healthcare assessment 1 5------disagreement about healthcare recommendations between social work and health services 1 2- --11-- -- -
Healthcare Arrangements 13 50 - 1 1 - - - - - 2 - Healthcare Arrangements (no additional detail) 5 ------awaiting completion of healthcare arrangements (incl. awaiting equipment supplied by health only) 1 1-1------awaiting bed availability in other NHS hospital/specialty/facility 12 48------2- awaiting bed availability in non-NHS facility (eg hospice) ------awaiting availability of transport ------awaiting routine discharge - 1- -1------
Legal/Financial 22 28 - 3 3 6 1 8 - - - - Legal Financial (no additional detail)5 ------legal issues (including intervention by patient’s lawyer) 3 6-2- -1 -- -- - financial and personal assets problem 19 22-136-8- -- -
Disagreements 14 25 - 4 - - 1 2 1 - - - Disagreements (no additional detail)5 - 1------1-- - internal family dispute issues 2 3------disagreement between patient/carer and health services 5 6-1------disagreement between patient/carer and social work services 3 4- -- --1- -- - disagreement between family and health services 2 4-1- -11- -- - disagreement between family and social work services 5 7-2------
Other patient/carer/family related reasons 44 63 - 1 2 1 3 15 - 1 1 - Other (no additional detail)5 1 1------1- - patient exercising statutory right of choice 38 52 - - - 1 3 15 - - - - patient does not qualify for care ------family/relatives arranging care 2 3- -1------other patient/carer/family-related reason 3 7-11-- -- -1 -
Principal reason not agreed ------
Reason for delay not recorded ------
1. Number of patients ready for discharge with a duration of over 6 weeks (43 days or more), ie the common period for discharge planning agreement timescales across Scotland. /continued 2. Total number of patients ready for discharge, in all specialties, reported as at July 2006 census. 3. All figures are based on NHS board area of treatment. There are however, a small number of patients experiencing a delay in discharge who are residents of other NHS Board areas. This may mean that the NHS board area of treatment is not responsible for the patient's post hospital discharge planning. As at the July 2006 census NHS Clyde (NHS Greater Glasgow) had 4 residents from NHS Ayrshire & Arran and 1 resident from NHS Greater Glasgow; NHS Fife had 1 resident from NHS Tayside; NHS Greater Glasgow had 2 residents from NHS Fife and 3 residents from NHS Lanarkshire; NHS Lanarkshire had 2 residents from NHS Greater Glasgow; NHS Grampian had 1 resident from NHS Orkney; NHS Tayside had 3 residents from NHS Fife; NHS Forth Valley had 1 resident from NHS Fife. 4. The number of patients ready for discharge who are within the six week discharge planning period (42 days or less). 5. On a number of occasions the reason was recorded to category level only. 6. From the July 2006 census code 11 has been split to reflect whether the assessment was awaiting commencement (11A) or completion (11B). 7.The principal reason will not be shown for areas with a small population where the total number of patients delayed for the area is 3 or less as at the census date. This is to avoid small numbers being identified. Patients Ready for Discharge in NHSScotland page 10 figures from July 2006 census / continued Table 2 This is an ISD Scotland National Statistics NHS - Patients ready for discharge release. Numbers by NHS board area of treatment and principal reason; as at July 2006 census
Patients ready for discharge
NHS Board area of treatment3 Fife Forth Valley Grampian Greater Glasgow Highland Principal Reason
No. No. No. No. No. No. No. No. No. No. outwith within outwith within outwith within outwith within outwith within 6wks 6wks5 6wks1 6wks 6wks 6wks 6wks 6wks 6wks 6wks [see previous and next page for total and other NHS Boards]
All reasons 56 38 31 47 45 84 101 91 9 6
Community Care Assessment 26 - 17 9 10 5 66 11 - - 5 Community Care Assessment (no additional detail) ------awaiting commencement of post-hospital social care assessment 6 16 - 3 2 4 - 13 1 - - awaiting completion of post-hospital social care assessment6 10 - 14 7 6 3 52 9 - - post-hospital social care assessment completed: awaiting agreement of senior Social work practitioner -----211- - disagreement about social care recommendations between social work and health services ------
Community Care Arrangements 27 29 12 36 23 66 32 65 - - Community Care Arrangements (no additional detail) 5 ------awaiting re-start services to discharge home ------awaiting new services to discharge home - -1 -2 - - 1 - - non-availability of public funding to purchase Resid'l/Nursing Home Place (no add'l detail): ------Residential Home place - -- --2-4- - Nursing Home place - -- -4 21 7 - - awaiting place availability (no additional detail): - -- --1- -- - in Local Authority Residential Home - -261222- - in Independent Residential Home 6 8-1- -12- - in Nursing Home (not NHS funded) 8 11 8 21 13 47 23 22 - - in Specialist Residential Facility for younger age groups (<65) - --1-6316- - in Specialist Residential Facility for older age groups (65+) - --6-1-3- - awaiting completion of social care arrangements (no additional detail): ------Local Authority Residential Home placement ------Independent Residential Home placement --1----1- - Nursing Home placement (not NHS funded) ------In order to live in their own home - awaiting social support (eg carer) 84- --1-4- - In order to live in their own home - awaiting procurement/delivery of equipment/adaptations fitted 32- -3211- - Specialist Housing provision 24-1-212- -
Healthcare Assessment --11--1-- - Healthcare Assessment (no additional detail)5 ------awaiting commencement/completion of post-hospital healthcare assessment --11--1-- - disagreement about healthcare recommendations between social work and health services ------
Healthcare Arrangements 221-108-1- - Healthcare Arrangements (no additional detail) 5 ------awaiting completion of healthcare arrangements (incl. awaiting equipment supplied by health only) ------awaiting bed availability in other NHS hospital/specialty/facility 221-108-1- - awaiting bed availability in non-NHS facility (eg hospice) ------awaiting availability of transport ------awaiting routine discharge ------
Legal/Financial ---114--- - 5 Legal Financial (no additional detail) ------legal issues (including intervention by patient’s lawyer) - -- -1 1 - - - - financial and personal assets problem - --1-3- -- -
Disagreements -2- -11221 - 5 Disagreements (no additional detail) ------internal family dispute issues -1----11- - disagreement between patient/carer and health services - 1- -11-1- - disagreement between patient/carer and social work services ------disagreement between family and health services ------disagreement between family and social work services ------1 -1 -
Other patient/carer/family related reasons 15-----128 6 Other (no additional detail)5 ------patient exercising statutory right of choice 15-----98 6 patient does not qualify for care ------family/relatives arranging care ------1- - other patient/carer/family-related reason ------2- -
Principal reason not agreed ------
Reason for delay not recorded ------
1. Number of patients ready for discharge with a duration of over 6 weeks (43 days or more), ie the common period for discharge planning agreement timescales across Scotland. /continued 2. Total number of patients ready for discharge, in all specialties, reported as at July 2006 census. 3. All figures are based on NHS board area of treatment. There are however, a small number of patients experiencing a delay in discharge who are residents of other NHS Board areas. This may mean that the NHS board area of treatment is not responsible for the patient's post hospital discharge planning. As at the July 2006 census NHS Clyde (NHS Greater Glasgow) had 4 residents from NHS Ayrshire & Arran and 1 resident from NHS Greater Glasgow; NHS Fife had 1 resident from NHS Tayside; NHS Greater Glasgow had 2 residents from NHS Fife and 3 residents from NHS Lanarkshire; NHS Lanarkshire had 2 residents from NHS Greater Glasgow; NHS Grampian had 1 resident from NHS Orkney; NHS Tayside had 3 residents from NHS Fife; NHS Forth Valley had 1 resident from NHS Fife. 4. The number of patients ready for discharge who are within the six week discharge planning period (42 days or less). 5. On a number of occasions the reason was recorded to category level only. 6. From the July 2006 census code 11 has been split to reflect whether the assessment was awaiting commencement (11A) or completion (11B). 7.The principal reason will not be shown for areas with a small population where the total number of patients delayed for the area is 3 or less as at the census date. This is to avoid small numbers being identified. page 11 Patients Ready for Discharge in NHSScotland figures from July 2006 census / continued Table 2 This is an ISD Scotland National Statistics NHS - Patients ready for discharge release. Numbers by NHS board area of treatment and principal reason; as at July 2006 census
Patients ready for discharge
NHS Board area of treatment3 Lanarkshire Lothian Orkney Shetland7 Principal Reason
No. No. No. No. No. No. No. No. within outwith within outwith within outwith within outwith 6wks5 6wks1 6wks 6wks 6wks 6wks 6wks 6wks [see previous and next page for other NHS Boards]
All reasons 50 17 126 70 - 6 1 1
Community Care Assessment 412304---- Community Care Assessment (no additional detail)5 ------awaiting commencement of post-hospital social care assessment 6 3-7----- awaiting completion of post-hospital social care assessment6 382234---- post-hospital social care assessment completed: awaiting agreement of senior Social work practitioner ------disagreement about social care recommendations between social work and health services ------
Community Care Arrangements 7147264-311 Community Care Arrangements (no additional detail) 5 ------awaiting re-start services to discharge home ------awaiting new services to discharge home - - 14 4 - - - - non-availability of public funding to purchase Resid'l/Nursing Home Place (no add'l detail): ------Residential Home place -2------Nursing Home place 58------awaiting place availability (no additional detail): ------in Local Authority Residential Home --77-2-- in Independent Residential Home --63---- in Nursing Home (not NHS funded) - 2 38 45 - - - - in Specialist Residential Facility for younger age groups (<65) - - 1 1 - - - - in Specialist Residential Facility for older age groups (65+) ------awaiting completion of social care arrangements (no additional detail): ------Local Authority Residential Home placement ------Independent Residential Home placement ------Nursing Home placement (not NHS funded) ------In order to live in their own home - awaiting social support (eg carer) 1 ------In order to live in their own home - awaiting procurement/delivery of equipment/adaptations fitted - - 1 - - 1 - - Specialist Housing provision 1254 - - - -
Healthcare Assessment --1----- Healthcare Assessment (no additional detail)5 ------awaiting commencement/completion of post-hospital healthcare assessment - - 1 - - - - - disagreement about healthcare recommendations between social work and health services ------
Healthcare Arrangements 1-201---- Healthcare Arrangements (no additional detail) 5 ------awaiting completion of healthcare arrangements (incl. awaiting equipment supplied by health only) ------awaiting bed availability in other NHS hospital/specialty/facility 1 - 20 1 - - - - awaiting bed availability in non-NHS facility (eg hospice) ------awaiting availability of transport ------awaiting routine discharge ------
Legal/Financial ------Legal Financial (no additional detail)5 ------legal issues (including intervention by patient’s lawyer) ------financial and personal assets problem ------
Disagreements 1-1--3-- Disagreements (no additional detail)5 ------internal family dispute issues ------disagreement between patient/carer and health services ------disagreement between patient/carer and social work services 1 ------disagreement between family and health services --1----- disagreement between family and social work services - - - - - 3 - -
Other patient/carer/family related reasons -121---- Other (no additional detail)5 ------patient exercising statutory right of choice ---1---- patient does not qualify for care ------family/relatives arranging care -1------other patient/carer/family-related reason --2-----
Principal reason not agreed ------
Reason for delay not recorded ------
1. Number of patients ready for discharge with a duration of over 6 weeks (43 days or more), ie the common period for discharge planning agreement timescales across Scotland. 2. Total number of patients ready for discharge, in all specialties, reported as at July 2006 census. 3. All figures are based on NHS board area of treatment. There are however, a small number of patients experiencing a delay in discharge who are residents of other NHS Board areas. This may mean that the NHS board area of treatment is not responsible for the patient's post hospital discharge planning. As at the July 2006 census NHS Clyde (NHS Greater Glasgow) had 4 residents from NHS Ayrshire & Arran and 1 resident from NHS Greater Glasgow; NHS Fife had 1 resident from NHS Tayside; NHS Greater Glasgow had 2 residents from NHS Fife and 3 residents from NHS Lanarkshire; NHS Lanarkshire had 2 residents from NHS Greater Glasgow; NHS Grampian had 1 resident from NHS Orkney; NHS Tayside had 3 residents from NHS Fife; NHS Forth Valley had 1 resident from NHS Fife. 4. The number of patients ready for discharge who are within the six week discharge planning period (42 days or less). 5. On a number of occasions the reason was recorded to category level only. 6. From the July 2006 census code 11 has been split to reflect whether the assessment was awaiting commencement (11A) or completion (11B). 7.The principal reason will not be shown for areas with a small population where the total number of patients delayed for the area is 3 or less as at the census date. This is to avoid small numbers being identified. page 12 Patients Ready for Discharge in NHSScotland figures from July 2006 census / continued Table 2 This is an ISD Scotland National Statistics NHS - Patients ready for discharge release. Numbers by NHS board area of treatment and principal reason; as at July 2006 census
Patients ready for discharge
NHS Board area of treatment3 Tayside Western Isles National Waiting Principal Reason Times Centre Board
No. No. No. No. No. No. within outwith within outwith within outwith 6wks5 6wks1 6wks 6wks 6wks 6wks [see previous pages for other NHS Boards]
All reasons 59 52 5 3 - -
Community Care Assessment 22 3 - - - - Community Care Assessment (no additional detail)5 ------awaiting commencement of post-hospital social care assessment 6 61---- awaiting completion of post-hospital social care assessment6 16 2 - - - - post-hospital social care assessment completed: awaiting agreement of senior Social work practitioner ------disagreement about social care recommendations between social work and health services ------
Community Care Arrangements 34 45 4 3 - - Community Care Arrangements (no additional detail) 5 ------awaiting re-start services to discharge home ------awaiting new services to discharge home 76---- non-availability of public funding to purchase Resid'l/Nursing Home Place (no add'l detail): ------Residential Home place 5----- Nursing Home place 11 8 - - - - awaiting place availability (no additional detail): ------in Local Authority Residential Home 1812 - - in Independent Residential Home 33---- in Nursing Home (not NHS funded) 3102 1 - - in Specialist Residential Facility for younger age groups (<65) ------in Specialist Residential Facility for older age groups (65+) - 1 - - - - awaiting completion of social care arrangements (no additional detail): ------Local Authority Residential Home placement ------Independent Residential Home placement ------Nursing Home placement (not NHS funded) ------In order to live in their own home - awaiting social support (eg carer) ------In order to live in their own home - awaiting procurement/delivery of equipment/adaptations fitted - - 1 - - - Specialist Housing provision 49----
Healthcare Assessment 1----- Healthcare Assessment (no additional detail)5 ------awaiting commencement/completion of post-hospital healthcare assessment 1 - - - - - disagreement about healthcare recommendations between social work and health services ------
Healthcare Arrangements ------Healthcare Arrangements (no additional detail) 5 ------awaiting completion of healthcare arrangements (incl. awaiting equipment supplied by health only) ------awaiting bed availability in other NHS hospital/specialty/facility ------awaiting bed availability in non-NHS facility (eg hospice) ------awaiting availability of transport ------awaiting routine discharge ------
Legal/Financial 1----- Legal Financial (no additional detail)5 ------legal issues (including intervention by patient’s lawyer) 1----- financial and personal assets problem ------
Disagreements -3---- Disagreements (no additional detail)5 ------internal family dispute issues ------disagreement between patient/carer and health services - 1 - - - - disagreement between patient/carer and social work services - 2 - - - - disagreement between family and health services ------disagreement between family and social work services ------
Other patient/carer/family related reasons 111 - - - Other (no additional detail)5 ------patient exercising statutory right of choice 111 - - - patient does not qualify for care ------family/relatives arranging care ------other patient/carer/family-related reason ------
Principal reason not agreed ------
Reason for delay not recorded ------
1. Number of patients ready for discharge with a duration of over 6 weeks (43 days or more), ie the common period for discharge planning agreement timescales across Scotland. 2. Total number of patients ready for discharge, in all specialties, reported as at July 2006 census. 3. All figures are based on NHS board area of treatment. There are however, a small number of patients experiencing a delay in discharge who are residents of other NHS Board areas. This may mean that the NHS board area of treatment is not responsible for the patient's post hospital discharge planning. As at the July 2006 census NHS Clyde (NHS Greater Glasgow) had 4 residents from NHS Ayrshire & Arran and 1 resident from NHS Greater Glasgow; NHS Fife had 1 resident from NHS Tayside; NHS Greater Glasgow had 2 residents from NHS Fife and 3 residents from NHS Lanarkshire; NHS Lanarkshire had 2 residents from NHS Greater Glasgow; NHS Grampian had 1 resident from NHS Orkney; NHS Tayside had 3 residents from NHS Fife; NHS Forth Valley had 1 resident from NHS Fife. 4. The number of patients ready for discharge who are within the six week discharge planning period (42 days or less). 5. On a number of occasions the reason was recorded to category level only. 6. From the July 2006 census code 11 has been split to reflect whether the assessment was awaiting commencement (11A) or completion (11B). 7.The principal reason will not be shown for areas with a small population where the total number of patients delayed for the area is 3 or less as at the census date. This is to avoid small numbers being identified. page 13 Patients Ready for Discharge in NHSScotland figures from July 2006 census Table 3 This is an ISD Scotland National Statistics NHS - Patients ready for discharge release. Numbers by Local Authority Partner and principal reason; as at July 2006 census
Patients ready for discharge Local Authority Partner4
Principal Reason Number Total2 Argyll & Bute W Dunbarton- Inverclyde Renfrewshire Scottish East Ayrshire North Ayrshire outwith the shire Borders six week discharge No. No. No. No. No. No. No. No. No. No. No. No. No. No. planning within outwith within outwith within outwith within outwith within outwith within outwith within outwith 1 period 6wks3 6wks1 6wks 6wks 6wks 6wks 6wks 6wks 6wks 6wks 6wks 6wks 6wks 6wks
[ see next page for other local authority partners ]
All reasons (including Health Care reasons)4 627 1243 19 60 20 25 17 17 16 16 12 16 12 11 25 38
5 All reasons considered to have Social Work Involvement 612 1186 19 59 20 25 17 17 16 15 12 16 12 11 25 38
Community Care Assessment 71 350 6 15 13 2 6 1 4 - 5 5 10 3 21 6 6 Community Care Assessment (no additional detail) ------7 awaiting commencement of post-hospital social care assessment 6 65 112---1-11--5- 7 awaiting completion of post-hospital social care assessment 57 271 5141124-3-4381155 post-hosp social care assessment completed: awaiting agreement of senior social work practitioner 8 14 ----21---12211 disagreement about social care recommendations between soc work and health services ------
Community Care Arrangements 458 720 13 37 7 22 8 12 10 12 6 10 - 1 2 17 6 Community Care Arrangements (no additional detail) ------awaiting re-start services to discharge home - 2 ----1------awaiting new services to discharge home 13 44 3-1-----2----- non-availablty of public fundng to purchase Residential/Nursng Home Place: ------Residential Home place 14 22 31------5 Nursing Home place 48 79 ------79----210 awaiting place availability: 2 6 ------41---- in Local Authority Residential Home 36 50 -412-----1---- in Independent Residential Home 29 49 3711------1-- in Nursing Home (not NHS funded) 208 318 133186102--4- --1 in Specialist Residential Facility for younger age groups (<65) 24 28 ---1------in Specialist Residential Facility for older age groups (65+) 15 15 -----1---3---- awaiting completion of social care arrangements: 1 ------Local Authority Residential Home placement 2 2 -2------Independent Residential Home placement 12 13 -11------Nursing Home placement (not NHS funded) 2 2 -2------In order to live in their own home - awaiting social support (eg carer) 16 28 36-----1------In order to live in their own home - awaiting procurement/delivery of equipment/adaptations fitted 8 18 -1----11------Specialist Housing provision 29 43 - -1-11-1-1- --1
Healthcare Assessment 4 27------1------6 Healthcare Assessment (no additional detail) ------awaiting commencement/completion of post-hospital healthcare assessment 1 5 ------disagreement about healthcare recommendations between social work and health services 1 2 ------1------
Healthcare Arrangements 4 1350-1------6 Healthcare Arrangements (no additional detail) ------awaiting completion of healthcare arrangements (incl. awaiting equipment supplied by health only) 1 1 -1------awaiting bed availability in other NHS hospital/specialty/facility 12 48 ------awaiting bed availability in non-NHS facility (eg hospice) ------awaiting availability of transport ------awaiting routine discharge - 1 ------
Legal Financial 2228-3--1422-----5 6 Legal Financial (no additional detail) ------legal issues (including intervention by patient’s lawyer) 3 6 -2------financial and personal assets problem 19 22 -1- -1422- -- --5
Disagreements 1725-3------1-11-1 6 Disagreements (no additional detail) - 1 ------1----- internal family dispute issues 2 3 ------disagreement between patient/carer and health services 5 6 -1------disagreement between patient/carer and social work services 3 4 ------1 disagreement between family and health services 2 4 -1------11-- disagreement between family and social work services 5 7 -1------
Other patient/carer/family related reasons 44 63 - 1 - 1 2 - - 1 - 1 1 6 2 9 6 Other (no additional detail) 1 1 ------1---- patient exercising statutory right of choice 38 52 ---1---1--1629 patient does not qualify for care ------family/relatives arranging care 2 3 ----1------other patient/carer/family-related reason 3 7 -1--1------
Principal reason not agreed ------
Reason for delay not recorded ------
1. Number of patients ready for discharge with a duration of over 6 weeks (43 days or more), ie the common period for discharge planning agreement timescales across Scotland. / continued 2. Total number of patients ready for discharge, in all specialties, reported as at July 2006 census. 3. The number of patients ready for discharge who are within the six week discharge planning period (42 days or less). 4. A patient ready for discharge is not considered to have social work involvement in the discharge planning process if the principal reason for delay is in the Healthcare groups. 5. A patient ready for discharge is considered to have Social Work involvement if: EITHER - he/she has Principal Reason 'Community Care Assessment' or 'Community Care Arrangements'; OR - he/she has Principal Reason in the 'Patient/Carer/Family - related' categories, OR Principal Reason not agreed, OR Principal Reason not recorded AND a date of referral for Social Care Assessment has been recorded. 6. On a number of occasions the reason was recorded to category level only. 7. From the July 2006 census code 11 has been split to reflect whether the assessment was awaiting commencement (11A) or completion (11B). 8.The principal reason will not be shown for areas with a small population where the total number of patients delayed for the area is 3 or less as at the census date. This is to avoid small numbers being identified.
Patients Ready for Discharge in NHSScotland page 14 figures from July 2006 census / continued Table 3 This is an ISD Scotland National Statistics NHS - Patients ready for discharge release. Numbers by Local Authority Partner and principal reason; as at July 2006 census
Patients ready for discharge Local Authority Partner4
Principal Reason South Ayrshire Dumfries & Fife Clackmannan - Falkirk Stirling Aberdeen City Aberdeenshire Galloway shire
No. No. No. No. No. No. No. No. No. No. No. No. No. No. No. No. within outwith within outwith within outwith within outwith within outwith within outwith within outwith within outwith 6wks3 6wks1 6wks 6wks 6wks 6wks 6wks 6wks 6wks 6wks 6wks 6wks 6wks 6wks 6wks 6wks
[ see previous page for total and other local authority partners ]
All reasons (including Health Care reasons)4 17 27 5 1 56 40 - - 22 33 9 13 19 52 22 23
All reasons considered to have Social Work Involvement5 16 27 3 1 54 38 - - 21 33 8 12 12 45 19 22
Community Care Assessment 841-28-- -145343263 6 Community Care Assessment (no additional detail) ------7 awaiting commencement of post-hospital social care assessment - - - -16- - -2 -1 22 -2 - 7 awaiting completion of post-hospital social care assessment 841-12-- -125221142 post-hosp social care assessment completed: awaiting agreement of senior social work practitioner ------1-1 disagreement about social care recommendations between soc work and health services ------
Community Care Arrangements 7201 12531- - 7275 8 9421215 6 Community Care Arrangements (no additional detail) ------awaiting re-start services to discharge home 1------awaiting new services to discharge home --11------1-2--- non-availablty of public fundng to purchase Residential/Nursng Home Place: ------Residential Home place ------2 Nursing Home place -1------42 awaiting place availability: ------1 in Local Authority Residential Home ------1511-11- in Independent Residential Home 13--59---1------in Nursing Home (not NHS funded) 515- - 712- - 6132 7 7335 6 in Specialist Residential Facility for younger age groups (<65) ------1---5-1 in Specialist Residential Facility for older age groups (65+) ------6---1-- awaiting completion of social care arrangements: ------Local Authority Residential Home placement ------Independent Residential Home placement ------1----- Nursing Home placement (not NHS funded) ------In order to live in their own home - awaiting social support (eg carer) ----84------1 In order to live in their own home - awaiting procurement/delivery of equipment/adaptations fitted ----32------121 Specialist Housing provision -1- -24- --1- --1-1
Healthcare Assessment 4 1------11---- 6 Healthcare Assessment (no additional detail) ------awaiting commencement/completion of post-hospital healthcare assessment ------11---- disagreement about healthcare recommendations between social work and health services 1------
Healthcare Arrangements 4 --2-22--1---7731 6 Healthcare Arrangements (no additional detail) ------awaiting completion of healthcare arrangements (incl. awaiting equipment supplied by health only) ------awaiting bed availability in other NHS hospital/specialty/facility - -2-22- -1-- -7731 awaiting bed availability in non-NHS facility (eg hospice) ------awaiting availability of transport ------awaiting routine discharge ------
Legal Financial 13------1---1-3 6 Legal Financial (no additional detail) ------legal issues (including intervention by patient’s lawyer) 1------1 financial and personal assets problem -3------1- --1-2
Disagreements -----2------11 6 Disagreements (no additional detail) ------internal family dispute issues -----1------disagreement between patient/carer and health services -----1------11 disagreement between patient/carer and social work services ------disagreement between family and health services ------disagreement between family and social work services ------
Other patient/carer/family related reasons - - 1 - 1 5 ------6 Other (no additional detail) ------patient exercising statutory right of choice ----15------patient does not qualify for care ------family/relatives arranging care ------other patient/carer/family-related reason --1------
Principal reason not agreed ------
Reason for delay not recorded ------
1. Number of patients ready for discharge with a duration of over 6 weeks (43 days or more), ie the common period for discharge planning agreement timescales across Scotland. / continued 2. Total number of patients ready for discharge, in all specialties, reported as at July 2006 census. 3. The number of patients ready for discharge who are within the six week discharge planning period (42 days or less). 4. A patient ready for discharge is not considered to have social work involvement in the discharge planning process if the principal reason for delay is in the Healthcare groups. 5. A patient ready for discharge is considered to have Social Work involvement if: EITHER - he/she has Principal Reason 'Community Care Assessment' or 'Community Care Arrangements'; OR - he/she has Principal Reason in the 'Patient/Carer/Family - related' categories, OR Principal Reason not agreed, OR Principal Reason not recorded AND a date of referral for Social Care Assessment has been recorded. 6. On a number of occasions the reason was recorded to category level only. 7. From the July 2006 census code 11 has been split to reflect whether the assessment was awaiting commencement (11A) or completion (11B). 8.The principal reason will not be shown for areas with a small population where the total number of patients delayed for the area is 3 or less as at the census date. This is to avoid small numbers being identified.
Patients Ready for Discharge in NHSScotland page 15 figures from July 2006 census / continued Table 3 This is an ISD Scotland National Statistics NHS - Patients ready for discharge release. Numbers by Local Authority Partner and principal reason; as at July 2006 census
Patients ready for discharge
Local Authority Partner4
Principal Reason Moray E Dunbarton - Glasgow City East Renfrew - Highland North Lanark- South Lanark- City of East Lothian shire shire shire shire Edinburgh
No. No. No. No. No. No. No. No. No. No. No. No. No. No. No. No. No. No. within outwith within outwith within outwith within outwith within outwith within outwith within outwith within outwith within outwith 6wks3 6wks1 6wks 6wks 6wks 6wks 6wks 6wks 6wks 6wks 6wks 6wks 6wks 6wks 6wks 6wks 6wks 6wks
[ see previous and next page for total and other local authority partners ]
All reasons (including Health Care reasons)4 3 99 8696161596251232128462147
All reasons considered to have Social Work Involvement5 3 99 8686051596251231126861137
Community Care Assessment 1 - 6 2 47 7 4 2 - - 20 - 23 3 20 3 5 1 6 Community Care Assessment (no additional detail) ------7 awaiting commencement of post-hospital social care assessment - - - -101 - - - -1 -2 -4 -1 - 7 awaiting completion of post-hospital social care assessment 1 - 5 1 37 6 4 2 - - 19 - 21 3 16 3 4 1 post-hosp social care assessment completed: awaiting agreement of senior social work practitioner --11------disagreement about social care recommendations between soc work and health services ------
Community Care Arrangements 2 9 1 5 21 43 1 12 - - 5 12 7 7 46 58 7 5 6 Community Care Arrangements (no additional detail) ------awaiting re-start services to discharge home ------awaiting new services to discharge home -----1------631- non-availablty of public fundng to purchase Residential/Nursng Home Place: ------Residential Home place ------4---2------Nursing Home place --12-116--3524---- awaiting place availability: ------in Local Authority Residential Home -1---2------1-67-- in Independent Residential Home -----2------531- in Nursing Home (not NHS funded) 1 8 - 2 17 15 - 1 - - 1 4 3 - 26 40 4 5 in Specialist Residential Facility for younger age groups (<65) - -- 1314------1 1- - in Specialist Residential Facility for older age groups (65+) -----2-1------awaiting completion of social care arrangements: ------Local Authority Residential Home placement ------Independent Residential Home placement -----1------Nursing Home placement (not NHS funded) ------In order to live in their own home - awaiting social support (eg carer) -----3----1--1---- In order to live in their own home - awaiting procurement/delivery of equipment/adaptations fitted 1---1------1--1--- Specialist Housing provision -----2------12141-
Healthcare Assessment 4 ----1------1--- 6 Healthcare Assessment (no additional detail) ------awaiting commencement/completion of post-hospital healthcare assessment ----1------1--- disagreement about healthcare recommendations between social work and health services ------
Healthcare Arrangements 4 -----11-----1-1511- 6 Healthcare Arrangements (no additional detail) ------awaiting completion of healthcare arrangements (incl. awaiting equipment supplied by health only) ------awaiting bed availability in other NHS hospital/specialty/facility -----1------1-1511- awaiting bed availability in non-NHS facility (eg hospice) ------awaiting availability of transport ------awaiting routine discharge ------1------
Legal Financial ------6 Legal Financial (no additional detail) ------legal issues (including intervention by patient’s lawyer) ------financial and personal assets problem ------
Disagreements --2--2--1---1-1--- 6 Disagreements (no additional detail) ------internal family dispute issues --1--1------disagreement between patient/carer and health services -----1------disagreement between patient/carer and social work services ------1----- disagreement between family and health services ------1--- disagreement between family and social work services --1-----1------
Other patient/carer/family related reasons - - - 1 - 8 - 1 8 6 - - - 2 1 - 1 1 6 Other (no additional detail) ------patient exercising statutory right of choice -----6-186---1---1 patient does not qualify for care ------family/relatives arranging care -----1------1---- other patient/carer/family-related reason ---1-1------1-1-
Principal reason not agreed ------
Reason for delay not recorded ------
1. Number of patients ready for discharge with a duration of over 6 weeks (43 days or more), ie the common period for discharge planning agreement timescales across Scotland. / continued 2. Total number of patients ready for discharge, in all specialties, reported as at July 2006 census. 3. The number of patients ready for discharge who are within the six week discharge planning period (42 days or less). 4. A patient ready for discharge is not considered to have social work involvement in the discharge planning process if the principal reason for delay is in the Healthcare groups. 5. A patient ready for discharge is considered to have Social Work involvement if: EITHER - he/she has Principal Reason 'Community Care Assessment' or 'Community Care Arrangements'; OR - he/she has Principal Reason in the 'Patient/Carer/Family - related' categories, OR Principal Reason not agreed, OR Principal Reason not recorded AND a date of referral for Social Care Assessment has been recorded. 6. On a number of occasions the reason was recorded to category level only. 7. From the July 2006 census code 11 has been split to reflect whether the assessment was awaiting commencement (11A) or completion (11B). 8.The principal reason will not be shown for areas with a small population where the total number of patients delayed for the area is 3 or less as at the census date. This is to avoid small numbers being identified. Patients Ready for Discharge in NHSScotland page 16 figures from July 2006 census / continued Table 3 This is an ISD Scotland National Statistics NHS - Patients ready for discharge release. Numbers by Local Authority Partner and principal reason; as at July 2006 census
Patients ready for discharge Local Authority Partner4
Principal Reason Mid-lothian West Lothian Orkney Shetland8 Angus Dundee City Perth & Kinross Comhairle nan Local Authority Eilean Siar Partner not identified No. No. No. No. No. No. No. No. No. No. No. No. No. No. No. No. No. No. within outwith within outwith within outwith within outwith within outwith within outwith within outwith within outwith within outwith 6wks3 6wks1 6wks 6wks 6wks 6wks 6wks 6wks 6wks 6wks 6wks 6wks 6wks 6wks 6wks 6wks 6wks 6wks
[ see previous pages for total and other local authority partners ]
All reasons (including Health Care reasons)4 17 1 11 - 1 7 - - 13 4 21 37 25 10 5 3 - -
All reasons considered to have Social Work Involvement5 13 1 11 - 1 7 1 1 13 4 20 37 25 10 5 3 - -
Community Care Assessment 5------6141101--- - 6 Community Care Assessment (no additional detail) ------7 awaiting commencement of post-hospital social care assessment 2------61---- 7 awaiting completion of post-hospital social care assessment 3------61414----- post-hosp social care assessment completed: awaiting agreement of senior social work practitioner ------disagreement about social care recommendations between soc work and health services ------
Community Care Arrangements 8111--3- -52163515743- - 6 Community Care Arrangements (no additional detail) ------awaiting re-start services to discharge home ------awaiting new services to discharge home 116-- -- -1-4323- --- non-availablty of public fundng to purchase Residential/Nursng Home Place: ------Residential Home place ------1---4----- Nursing Home place ------6751---- awaiting place availability: ------in Local Authority Residential Home 1----2----18--12-- in Independent Residential Home ------2-1111---- in Nursing Home (not NHS funded) 5 -3------2173121-- in Specialist Residential Facility for younger age groups (<65) ------in Specialist Residential Facility for older age groups (65+) ------1---- awaiting completion of social care arrangements: ------Local Authority Residential Home placement ------Independent Residential Home placement ------Nursing Home placement (not NHS funded) ------In order to live in their own home - awaiting social support (eg carer) ------In order to live in their own home - awaiting procurement/delivery of equipment/adaptations fitted -----1------1--- Specialist Housing provision 1-2-----1-39------
Healthcare Assessment 4 ------1------6 Healthcare Assessment (no additional detail) ------awaiting commencement/completion of post-hospital healthcare assessment ------1------disagreement about healthcare recommendations between social work and health services ------
Healthcare Arrangements 4 4------6 Healthcare Arrangements (no additional detail) ------awaiting completion of healthcare arrangements (incl. awaiting equipment supplied by health only) ------awaiting bed availability in other NHS hospital/specialty/facility 4------awaiting bed availability in non-NHS facility (eg hospice) ------awaiting availability of transport ------awaiting routine discharge ------
Legal Financial ----1---1------6 Legal Financial (no additional detail) ------legal issues (including intervention by patient’s lawyer) ----1---1------financial and personal assets problem ------
Disagreements -----4-----1-2--- - 6 Disagreements (no additional detail) ------internal family dispute issues ------disagreement between patient/carer and health services ------1------disagreement between patient/carer and social work services ------2---- disagreement between family and health services ------disagreement between family and social work services -----4------
Other patient/carer/family related reasons ------1 1 - - - - 1 - - - 6 Other (no additional detail) ------patient exercising statutory right of choice ------11----1--- patient does not qualify for care ------family/relatives arranging care ------other patient/carer/family-related reason ------
Principal reason not agreed ------
Reason for delay not recorded ------
1. Number of patients ready for discharge with a duration of over 6 weeks (43 days or more), ie the common period for discharge planning agreement timescales across Scotland. 2. Total number of patients ready for discharge, in all specialties, reported as at July 2006 census. 3. The number of patients ready for discharge who are within the six week discharge planning period (42 days or less). 4. A patient ready for discharge is not considered to have social work involvement in the discharge planning process if the principal reason for delay is in the Healthcare groups. 5. A patient ready for discharge is considered to have Social Work involvement if: EITHER - he/she has Principal Reason 'Community Care Assessment' or 'Community Care Arrangements'; OR - he/she has Principal Reason in the 'Patient/Carer/Family - related' categories, OR Principal Reason not agreed, OR Principal Reason not recorded AND a date of referral for Social Care Assessment has been recorded. 6. On a number of occasions the reason was recorded to category level only. 7. From the July 2006 census code 11 has been split to reflect whether the assessment was awaiting commencement (11A) or completion (11B). 8.The principal reason will not be shown for areas with a small population where the total number of patients delayed for the area is 3 or less as at the census date. This is to avoid small numbers being identified. Patients Ready for Discharge in NHSScotland page 17 figures from July 2006 census Table 4 This is an ISD Scotland National Statistics NHS - Patients ready for discharge release. Numbers by NHS Board area of treatment and by duration; as at July 2006 census
Patients ready for discharge NHS Board area of treatment1 Duration (weeks)3
Total2 123456789101112
Scotland 1243 50 137 114 111 113 91 60 53 46 52 48 30
Argyll (NHS Highland) 81 34112633 -64 - Clyde (NHS Greater Glasgow) 104 101067112763123 Ayrshire & Arran 126 410129108745444 Borders 28 -1173 -111131 Dumfries & Galloway 6 -2-12-1----- Fife 94 51371113796553 - Forth Valley 78 16211110223164 Grampian 129 59411115852554 Greater Glasgow 192 827181819117 7 9136 3 Highland 15 -2 -3131 -21 - - Lanarkshire 67 21913104232321- Lothian 196 824311923218107 4115 Orkney 6 ------1---1 Shetland 2 --1------Tayside 111 491711135366834 Western Isles 8 -112 -1 - - -1 -1 National Waiting Times Centre Board ------/ continued 1. All figures are based on NHS board area of treatment. There are however, a small number of patients experiencing a delay in discharge who are residents of other NHS Board areas. This may mean that the NHS board area of treatment is not responsible for the patient's post hospital discharge planning. As at the July 2006 census NHS Clyde (NHS Greater Glasgow) had 4 residents from NHS Ayrshire & Arran and 1 resident from NHS Greater Glasgow; NHS Fife had 1 resident from NHS Tayside; NHS Greater Glasgow had 2 residents from NHS Argyll & Clyde and 3 residents from NHS Lanarkshire; NHS Lanarkshire had 2 residents from NHS Greater Glasgow; NHS Grampian had 1 resident from NHS Orkney; NHS Tayside had 3 residents from NHS Fife; NHS Forth Valley had 1 resident from NHS Fife. 2 Total number of patients ready for discharge, in all specialties, reported as at July 2006 census. 3 Calculated on the number of cases where a ready for discharge date was recorded. Duration calculated from Ready for Discharge Date to July 2006 census date. Expressed in whole weeks (e.g. up to, and including, two weeks). 4 The number of patients ready for discharge who are within the six week discharge planning period. 5 Number of cases where Ready for Discharge Date was not recorded. 6 The number of patients ready for discharge with a duration of over 6 weeks (43 days or more), ie the common period for discharge planning agreement timescales across Scotland.
page 18 Patients Ready for Discharge in NHSScotland figures from July 2006 census / continued Table 4 This is an ISD Scotland National Statistics NHS - Patients ready for discharge release. Numbers by NHS Board area of treatment and by duration; as at July 2006 census
Patients ready for discharge 1 Duration (weeks)3 Duration (months)3 Total2 Number NHS Board area of treatment outwith the 0-64 7-12 3-5 6-8 9-11 12 + Not six week recorded5 discharge planning period6
616 289 249 51 21 17 - 1243 627 Scotland
17 16 30 9 4 5 - 81 64 Argyll (NHS Highland) 46 22 25 4 1 6 - 104 58 Clyde (NHS Greater Glasgow) 53 28 35 7 3 - - 126 73 Ayrshire & Arran 12 8 6 1 1 - - 28 16 Borders 51 ----- 61Dumfries & Galloway 56 28 10 - - - - 94 38 Fife 31 18 25 3 1 - - 78 47 Forth Valley 45 29 34 10 8 3 - 129 84 Grampian 101 45 31 9 3 3 - 192 91 Greater Glasgow 942----15 6 Highland 50 11 5 1 - - - 67 17 Lanarkshire 126 45 20 5 - - - 196 70 Lothian -231--- 66Orkney 1-1----21Shetland 59 30 21 1 - - - 111 52 Tayside 521---- 83Western Isles ------National Waiting Times Centre Board
1. All figures are based on NHS board area of treatment. There are however, a small number of patients experiencing a delay in discharge who are residents of other NHS Board areas. This may mean that the NHS board area of treatment is not responsible for the patient's post hospital discharge planning. As at the July 2006 census NHS Clyde (NHS Greater Glasgow) had 4 residents from NHS Ayrshire & Arran and 1 resident from NHS Greater Glasgow; NHS Fife had 1 resident from NHS Tayside; NHS Greater Glasgow had 2 residents from NHS Fife and 3 residents from NHS Lanarkshire; NHS Lanarkshire had 2 residents from NHS Greater Glasgow; NHS Grampian had 1 resident from NHS Orkney; NHS Tayside had 3 residents from NHS Fife; NHS Forth Valley had 1 resident from NHS Fife. 2 Total number of patients ready for discharge, in all specialties, reported as at July 2006 census. 3 Calculated on the number of cases where a ready for discharge date was recorded. Duration calculated from Ready for Discharge Date to July 2006 census date. Expressed in whole weeks (e.g. up to, and including, two weeks). 4 The number of patients ready for discharge who are within the six week discharge planning period. 5 Number of cases where Ready for Discharge Date was not recorded. 6 The number of patients ready for discharge with a duration of over 6 weeks (43 days or more), ie the common period for discharge planning agreement timescales across Scotland.
Patients Ready for Discharge in NHSScotland page 19 figures from July 2006 census This is an ISD Scotland Chart 2 National Statistics release. Patients ready for discharge by duration; as at July 2006 census: Scotland
The length of time a patient is delayed is calculated from the date they were clinically ready for discharge to the census date.
220
200
180
160
140
120
100 Number of patients 80
60
40
20
0 12 18 6 24 30 36 42 48 52+ Number of weeks
Chart 3
Patients ready for discharge who are outwith the six week discharge planning period by Specialty: Scotland; as at July 2006 census
All specialties show a increase between April 2006 and July 2006, except for Orthopaedics and Rehabilitation Medicine. Geriatric Medicine shows the largest increase, 409 at the July 2006 census compared with 321 at the April 2006 census. Mental Health Specialties increased from 100 at the April 2006 census to 120 at the July 2006 census, Medical Specialties (excluding rehabilitation medicine) increased from 27 at the April 2006 census to 41 at the July 2006 census and GP Other than Obstetrics increased from 31 at the April 2006 census to 43 at the July 2006 census.
Geriatric Medicine has both 'non continuing care' and ‘continuing care’ components. The implementation (for delayed discharges purposes only) in July 2006 of a new definition of ‘Geriatric Medicine’ means that it is expected to be possible for future censuses to separately identify nationally the number of patients experiencing a delay in discharge in an 'non continuing care' setting.
Geriatric Medicine
Mental Health Specialties (excluding learning disabilities)
GP Other than Obstetrics
Medical Specialties (excluding rehabilitation medicine) For each specialty group, the upper bar is July 2006 data; the lower bar is April 2006 data
Rehabilitation Medicine
Learning Disability
Orthopaedics
Surgical Specialties (excluding orthopaedics)
Other
0 100 200 300 400 500 600 Number of patients
Patients Ready for Discharge in NHSScotland figures from July 2006 census page 20 Chart 4 This is an ISD Scotland National Statistics release. Patients ready for discharge who are outwith the six week discharge planning period by Principal Reason; by Age Group: Scotland; as at July 2006 census
At the July 2006 census 75% of those patients outwith the six week discharge planning period were 75 years of age and over.
The largest increase in the numbers of patients ready for discharge outwith the six week discharge planning period were patients aged 75-84. There were 240 at the July 2006 census compared with 172 at the April 2006 census (there were 305 (-21.3%) at the July 2005 census.
160 Age Group 140
0-64 120 65-74
100 75-84
85+ 80
Number of patients of Number 60
40
20
0 Community Care Patients waiting to go Awaiting funding for a care Awaiting place availability Healthcare Assessment / Patient exercising statutory Legal/Financial Other Assessment reasons home home placement in a care home Arrangements right of choice Principal Reason
Other includes Disagreements; Other patient/carer/family related reasons excluding patient exercising statutory right of choice; Community Care Arrangements (no additional detail); awaiting completion of social care arrangements (no additional detail); Principal reason not agreed; and Principal reason not recorded.
Chart 5
Patients Ready for Discharge by Principal Reason Group and duration of delay: Scotland; as at July 2006 census
The reasons for delay are different for those patients who are within the six week and those outwith the six week discharge planning period. At the July 2006 census, of the 616 patients within the six weeks, 279 (45.3%) were delayed due to Community Care Assessment reasons, 153 (24.8%) were delayed due to Awaiting place availability in a care home, 69 (11.2%) were were waiting to go home, 42 (6.8%) were delayed due to Healthcare reasons, 39 (6.3%) were awaiting funding for a care home placement, 14 (2.3%) were exercising statutory right of choice, 14 (2.3%) were delayed due to other reasons and 6 (1.0%) were delayed due to legal/financial reasons.
627 patients were delayed more than 6 weeks at the July 2006 census. For those patients the main reasons for delay were awaiting place availability for a care home placement; Community Care Assessment reasons, patients waiting to go home, awaiting funding for a care home placement, patient exercising statutory right of choice, legal/financial reasons, other reasons and Healthcare reasons. At the July 2006 census for those patients delayed over 52 weeks, the main reason for delay was awaiting place availability for a care home placement, there were 11 cases at the July 2006 census. The reason for delay is the patients reason for delay as at the census point.
52+ Community Care Assessment reasons
Patients waiting to go home 39-52
Awaiting funding for a care home placement
26-38 Awaiting place availability in a care home
Healthcare Assessment / 13-25 Arrangements Duration (weeks) Duration
Patient exercising statutory right of choice
7-12 Legal/Financial
Other 0-6
0 100 200 300 400 500 600 700 800 Number of patients
Other includes Disagreements; Other patient/carer/family related reasons excluding patient exercising statutory right of choice; Community Care Arrangements (no additional detail); awaiting completion of social care arrangements (no additional detail); Principal reason not agreed; and Principal reason not recorded.
Patients Ready for Discharge in NHSScotland page 21 figures from July 2006 census
Appendices This is an ISD Scotland National Statistics release
All census-based information provides a 'snapshot' only of the position as at the July 2006 census, with some comparisons with earlier censuses. Due to definitional changes it has not been possible to identify the effect of these changes retrospectively, so that the comparisons in the report are with figures previously published, and may therefore in some instances overstate reductions or understate increases. These definitional changes are detailed in the introduction and background on page 2.
Appendix 1 Basic Approach
Certain features of the approach that has been taken to data collection are summarised below - an awareness of these characteristics is considered essential to understanding the information that is presented in this publication:
• The date that a patient is considered 'clinically ready for discharge' (ie the point of clinical readiness to move on to the next stage of care, whether or not health and social care assessments have been completed) has been adopted as a common national baseline. This centres around the criterion of multi-agency agreement that there is no further requirement for the healthcare provided in that bed. The "ready for discharge" national baseline does not preclude or encroach upon the aforementioned local discharge planning agreements.
• All the information in this publication has been designed to be of benefit to the local agencies in the arrangements they make for timely, appropriate and safe transfers to the next stage of care.
Patients Ready for Discharge in NHSScotland figures from July 2006 census page 22
Appendix 2 Definitions and terms
More comprehensive details on the following definitions and terms are available from ISD on request.
Ready for discharge A patient is ready for discharge when he/she is judged to be clinically ready to move on to the next stage of care (note that the 'next stage of care' includes destinations within and outwith the NHS). The definition covers both NHS hospital beds and beds contracted for NHS use in non-NHS facilities.
Patients ready for discharge over six weeks For most Local Authority Partners there is an accepted period beyond the clinically ready for discharge date during which all assessment and follow-on arrangements are put in place. The common period for discharge planning is six weeks, however locally this may differ for Local Authority Partners. Each Local Authority Partner agreement is designed to reflect local circumstances and arrangements for safe and appropriate transfers of patients to the next stage of care. For this reason the Scottish Executive Health Department, recognising the complexity which can surround the discharge planning and assessment process, have advised that whilst there should be no change in the national definitions, only data for those patients who have been ready for discharge for more than six weeks at the time of the census should be published in comprehensive form in the quarterly figures. Summary information on ‘total’ numbers of patients ready for discharge including those patients with a delay of less than six weeks at the time of the census will continue to be published.
Patients Ready for Discharge in NHSScotland figures from July 2006 census page 23
/continued Appendix 2 Definitions and terms This is an ISD Scotland National Statistics release
Ready-for-discharge date This is the date on which an inpatient is clinically ready to move on to the next stage of care. This date is determined by the consultant/GP responsible for the inpatient care, in consultation with all agencies involved in planning the patient's next stage of care -whether or not assessments by health and social care agencies have been completed.
NB Multi-agency discharge planning can be complex. The aim of the community care assessment process is to ensure that the patient's post-hospital care needs are met in full and this may require input from a range of health and social care agencies, as well as taking account of the patient's own wishes and family/carer issues. Aids and adaptations required for the patient's own home can also be a major consideration.
Social Work Involvement
A patient ready for discharge is considered to have Social Work involvement if: EITHER - he/she has Principal Reason 'Community Care Assessment' or 'Community Care Arrangements'; OR - he/she has Principal Reason in the 'Patient/Carer/Family - related' categories, OR Principal Reason not agreed, OR Principal Reason not recorded AND a date of referral for Social Care Assessment has been recorded.
Duration This is the period of time to the census point that the patient has remained in the bed awaiting the finalisation of arrangements for his/her safe transfer.
Reason This is the reason why the patient has remained in the bed awaiting the finalisation of arrangements for his/her safe transfer. For the national census, the principal reason that applies to each patient at the census point is recorded.
Patients Ready for Discharge in NHSScotland figures from July 2006 census page 24
/continued Appendix 2 Definitions and terms This is an ISD Scotland National Statistics release
Median/mean duration presentation, and frequency distribution This publication presents information on durations up to the census point. Two summary measures are provided:
Median duration - the middle value of any one set of duration values that are arranged in numerical order.
Mean duration - an average duration, calculated by summing all duration values in any one set and dividing by the number of cases in that set.
The frequency distributions for duration commonly show a relatively large proportion of cases experiencing fairly short durations and a relatively small number with longer durations. The median may therefore be taken as the best indicator of a "typical" duration for patients in a particular group (eg a particular NHS Board, or a particular reason category).
Appendix 3 Data quality This is an ISD Scotland National Statistics release
National information on patients clinically ready for discharge has been collected quarterly since the end of 2000, and it is known that there have been variations in local interpretation of the national standards.
The data featured in this publication has undergone rigorous verification and quality assurance procedures, which will be further developed. The data provided is considered to be of a high quality; this is due largely to the efforts of staff in NHS Boards and Local Authority Partners in liasing over data validation and fully verifying data locally between NHS and social services colleagues before submission to ISD. ISD has made every effort to facilitate ratification of the data by the agencies within the limitations imposed by the processing and publication timetable. Instances where data submitted is incomplete or lacks full detail have been minimised - the presentation of any such data in this publication is accompanied by relevant explanations. Data quality issues arising from the quality assurance and verification processes will be followed up with individual agencies.
This is a National Statistics publication. It has been produced to high professional standards set out in the National Statistics Code of Practice and Release Practice Protocol (available at http://www.statistics.gov.uk/about_ns/cop/default.asp). These statistics undergo regular quality assurance reviews to ensure that they meet customer needs. They are produced free from any political interference.
Patients Ready for Discharge in NHSScotland figures from July 2006 census page 25
Appendix 4 Census Dates This is an ISD Scotland National Statistics release
Since national recording began in 2000, the date of the quarterly census has generally been the 15th of the month in question. However, it is known that in some areas of Scotland there is local benefit in undertaking the national census on a date other than the 15th. Following discussions at the National Advisory Group on Delayed Discharges Information (formerly EMAWG) the date when the national census is undertaken can be determined by local organisations. ISD will now calculate any related statistics (for example, figures on duration of delay) from the actual census dates used. The areas where the July 2006 census was taken on a date other than the 15th are:
NHS Board Census Date
NHS Ayrshire & Arran 17th July 2006
NHS Greater Glasgow - South Division 18th July 2006 NHS Greater Glasgow - Primary Care 17th July 2006 Division 13th July 2006 NHS Highland 12th July 2006 NHS Lothian 14th July 2006 NHS Dumfries & Galloway
Patients Ready for Discharge in NHSScotland figures from July 2006 census page 26 Appendix 5 Supplementary Items This is an ISD Scotland National Statistics release.
NHS - Patients ready for discharge Complex Needs Patients awaiting place or bed availability where no appropriate facilities exist or no secondary code
From the July 2006 census patients categorised as 'Complex Needs' will be reported separately. The category Complex Needs (no secondary code) includes cases that partnerships are unable to, for reasons beyond their control, secure a patient’s safe, timely and appropriate discharge from hospital. Patients falling into this category are highlighted under Complex Needs (no secondary code). Directors of Social Work, NHS Board Chief Executives or their nominated representatives have reported these cases formally to ISD and the Scottish Executive. Prior to the July 2006 census these cases were included in the census totals [see 'About this report' in Introduction and background]. At the July 2006 census 5 cases were Complex Needs (no secondary code).
Prior to the April 2005 census patients awaiting place or bed availability where no appropriate facilities exist were included in the census totals. At the July 2006 census they have been reclassified as 'Complex Needs' [see 'About this report' in Introduction and background]. At the July 2006 census there were 33 cases awaiting place availability in Specialist Residential Facilities where no appropriate facilties exist compared with 22 at the April 2006 census (there were 13 cases at the July 2005 census). There were 8 cases at the July 2006 census, the same number as at the April 2006 census who were awaiting bed availability in other NHS hospital/specialty/facility where no appropriate facilties exist (there were 2 cases at the July 2005 census).
A total of 41 cases were awaiting place or bed availability where no appropriate facilities exist at the April 2006 census. 12 of these cases had been delayed for one year or more, of which 5 were awaiting place availability in Specialist Residential Facility for younger age groups (<65).
Number of patients ready for discharge delayed due to Complex Needs (awaiting place or bed availability where no appropriate facilities exist or no secondary code) by NHS Board area of treatment; as at July 2006 census
Patients ready for discharge NHS Board area of treatment Number Total2 outwith the awaiting place awaiting place awaiting bed six week patients delayed due availability in availability in availability in other discharge to Complex Needs Specialist Specialist NHS planning (no secondary code) Residential Facility Residential Facility hospital/specialty/ period1 (<65) (65+) facility
Scotland 42 46 5 12 21 8
Argyll (NHS Highland) ------Clyde (NHS Greater Glasgow) ------Ayrshire & Arran 88 1-25 Borders 22 -11 - Dumfries & Galloway 11 -1 - - Fife 22 2--- Forth Valley ------Grampian 22 --2- Greater Glasgow 22 2--- Highland ------Lanarkshire ------Lothian 56 -3 -3 Orkney ------Shetland 12 14 - 1 13 - Tayside 89 -63 - Western Isles ------National Waiting Times Centre Board ------
Number of patients ready for discharge delayed due to Complex Needs (awaiting place or bed availability where no appropriate facilities exist or no secondary code) by NHS Board area of treatment and duration of delay; as at July 2006 census
Patients ready for discharge NHS Board area of treatment Duration (weeks)3 Duration (months)3
Total2 0-64 7-12 3-5 6-8 9-11 12 + Scotland 46 4 9 11 7 3 12
Argyll (NHS Highland) ------Clyde (NHS Greater Glasgow) ------Ayrshire & Arran 8- 4-1-3 Borders 2- 1---1 Dumfries & Galloway 1- ----1 Fife 2- -11 -- Forth Valley ------Grampian 2- -11 -- Greater Glasgow 2- ----2 Highland ------Lanarkshire ------Lothian 61 ---14 Orkney ------Shetland 14 2 17121 Tayside 91 323 -- Western Isles ------National Waiting Times Centre Board ------
1 The number of patients ready for discharge with a duration of over 6 weeks (43 days or more), ie the common period for discharge planning agreement timescales across Scotland, who were classified as Complex Needs (awaiting place or bed availability where no appropriate facilities exist or no secondary code). 2 Total number of patients ready for discharge classified as Complex Needs (awaiting place or bed availability where no appropriate facilities exist or no secondary code), in all specialties, reported as at July 2006 census. 3 Calculated on the number of cases where a ready for discharge date was recorded. Duration calculated from Ready for Discharge Date to July 2006 census date. Expressed in whole weeks or months (e.g. up to, and including, six weeks). 4 The number of patients ready for discharge who are within the six week discharge planning period.
Patients Ready for Discharge in NHSScotland page 27 figures from July 2006 census /continued Appendix 5 Supplementary Items This is an ISD Scotland National Statistics release.
NHS - Patients ready for discharge Complex Needs Patients delayed due to the Adults with Incapacity Act at the time of the census Prior to the July 2005 census these cases were included in the census totals. At the July 2006 census they have been reclassified as 'Complex Needs' [see 'About this report' in Introduction and background].
At the July 2006 census there were 190 cases ready for discharge delayed due to the Adults with Incapacity Act at the time of the census compared with 201 at the April 2006 census (there were 125 cases at the July 2005 census). As at the July 2006 census 40 cases had been delayed within six weeks, 45 cases had been delayed between 7-12 weeks, 61 cases had been delayed between 3 5 months, 30 cases had been delayed between 6-8 months, 4 cases had been delayed between 9-11 months and 10 cases had been delayed for one year or more.
Number of patients ready for discharge delayed due to Complex Needs (Adults with Incapacity Act) at the time of the census by NHS Board area of treatment; as at July 2006 census
Patients ready for discharge NHS Board area of treatment Number Total number of outwith the patients delayed six week due to the Adults discharge with Incapacity Act planning at the time of the period1 census2
Scotland 150 190
Argyll (NHS Highland) 34 Clyde (NHS Greater Glasgow) 68 Ayrshire & Arran 88 Borders 11 Dumfries & Galloway 22 Fife 41 53 Forth Valley 89 Grampian 10 12 Greater Glasgow 31 42 Highland 10 12 Lanarkshire 13 16 Lothian 12 15 Orkney -- Shetland -- Tayside 58 Western Isles -- National Waiting Times Centre Board --
Number of patients ready for discharge delayed due to Complex Needs (Adults with Incapacity Act) at the time of the census by NHS Board area of treatment and duration of delay; as at July 2006 census
Patients ready for discharge NHS Board area of treatment Duration (weeks)3 Duration (months)3
Total2 0-64 7-12 3-5 6-8 9-11 12 + Scotland 190 40 45 61 30 4 10
Argyll (NHS Highland) 4 1 ---12 Clyde (NHS Greater Glasgow) 8 2-32-1 Ayrshire & Arran 8 - 331 - 1 Borders 1 - ---- 1 Dumfries & Galloway 2 --11-- Fife 53 12 16 14 11 - - Forth Valley 9 1 232 - 1 Grampian 12 2 253 - - Greater Glasgow 42 11 8 16 4 - 3 Highland 12 2 3313 - Lanarkshire 16 3 381 - 1 Lothian 15 3 633 - - Orkney ------Shetland ------Tayside 8 3 221 - - Western Isles ------National Waiting Times Centre Board ------
1 The number of patients ready for discharge with a duration of over 6 weeks (43 days or more), ie the common period for discharge planning agreement timescales across Scotland, who were classified as Complex Needs (Adults with Incapacity Act) at the time of the census. 2 Total number of patients ready for discharge classified as Complex Needs (Adults with Incapacity Act) at the time of the census, in all specialties, reported as at July 2006 census. 3 Calculated on the number of cases where a ready for discharge date was recorded. Duration calculated from Ready for Discharge Date to July 2006 census date. Expressed in whole weeks or months (e.g. up to, and including, six weeks). 4 The number of patients ready for discharge who are within the six week discharge planning period.
Patients Ready for Discharge in NHSScotland page 28 figures from July 2006 census This is an ISD Scotland Appendix 6 Effect of Change in Definition National Statistics release.
NHS - Patients ready for discharge The table below shows the effect of the change in definition to the census totals by Health Board area of Treatment. This change has resulted, for the July census, in the removal of 167 patients from the total number of delayed discharges who would formerly have been included. Of these 22 have been ready for discharge for over six weeks.
Total number and over 6 weeks by NHS Board area of treatment; as at the July 2006 Census
Patients ready for discharge NHS Board area of treatment All Cases3 Census Cases Planned Discharges4 Zero Delay4 Number Total2, 3 Number Total2 Number Total2 Total2 outwith outwith outwith the six the six the six week week week discharge discharge discharge planning planning planning period1, 3 period1 period1
Scotland 649 1410 627 1243 22 51 116
Argyll (NHS Highland) 66 84 64 81 22 1 Clyde (NHS Greater Glasgow) 58 106 58 104 -- 2 Ayrshire & Arran 75 131 73 126 22 3 Borders 17 31 16 28 11 2 Dumfries & Galloway 2111 6 11 4 Fife 38 98 38 94 -- 4 Forth Valley 47 80 47 78 -- 2 Grampian 85 131 84 129 12 - Greater Glasgow 94 214 91 192 3814 Highland 720615 15 - Lanarkshire 17 79 17 67 -3 9 Lothian 80 280 70 196 10 23 61 Orkney 6666 -- - Shetland 1212 -- - Tayside 53 129 52 111 1414 Western Isles 3838 -- - National Waiting Times Centre Board ------
1 The number of patients ready for discharge with a duration of over 6 weeks (43 days or more), ie the common period for discharge planning agreement timescales across Scotland, excluding Complex Needs cases (see Appendix 5). 2 Total number of patients ready for discharge excluding Complex Needs (see Appendix 5), in all specialties, reported as at July 2006 census. 3 Total number of patients ready for discharge as defined for the April 2006 census. This includes Census, Planned discharges and Zero delay cases and excludes Complex Needs cases (see Appendix 5). 4 These definitional changes are detailed in paragraphs 1 and 2 of the 'Introduction and Background - Effect of the Changes' (see page 2).
Patients Ready for Discharge in NHSScotland figures from July 2006 census Page 29 This is an ISD Scotland National Statistics release
Acknowledgements
ISD Scotland gratefully acknowledges the joint working, co-operation and goodwill of all agencies involved in discharge planning for NHS patients, without which this publication would not have been possible. Particular thanks are due to the efforts of the National Advisory Group on Delayed Discharges Information (formerly EMAWG) whose members determined the statistical content of this publication and to all involved in the provision and quality assurance of data.
Future publication and further information
The next national census is planned to take place on or around 15 October 2006 and is expected to be published in November 2006.
Requests for further information on any aspect of this data should be directed to :
Caroll Brown ISD Scotland e-mail [email protected]
phone 0131 275 6099
fax 0131 275 7504
INFORMATION SERVICES Gyle Square 1 South Gyle Crescent Edinburgh EH12 9EB Scotland UK
General enquiries National phone 0131-275 7777 International phone +44131 275 7777
@ NHS National Services Scotland This publication may be reproduced provided the source is fully acknowledged.
Patients Ready for Discharge in NHSScotland page 30 figures from July 2006 census