Delayed discharges: A symptom of the challenges facing health and social care (8 January 2025)

Summary

Delays in discharging patients from hospital affect people’s physical and mental health, and make it harder to admit others to hospital. This joint report by the Auditor General for Scotland and the Accounts Commission warns this has a significant effect, despite impacting only around three per cent of hospital patients. In Scotland, people medically ready to leave spent 720,000 unnecessary days in hospital in 2024/25. Whilst the full financial impact is unknown, the cost to the NHS in hospital days alone is an estimated £440 million a year.

Content

Key statistics highlighted in this report include:

• 17,915 - Number of times people experienced a delayed discharge in 2024/25
• 720,119 - The number of hospital bed days lost due to delayed discharges in 2024/25
• 1 in 9 - Proportion of beds occupied due to delayed discharges in 2024/25
• 3.2% - Delayed discharges as a proportion of adult inpatient discharges in 2024/25 

Report recommendations

Jointly, the Scottish Government, NHS Scotland, the Convention of Scottish Local Authorities (COSLA), Healthcare Improvement Scotland, integration authorities and their partner NHS boards and councils, should:

• Over the next 12 months, develop a consistent approach to evaluating and reporting on initiatives to improve delayed discharges, such as discharge without delay and the Lothian Partnership, and sharing best practice and areas for improvement. Evaluation should be reported annually and include assessing effectiveness, value for money, and whether the initiatives are improving the balance of care. This evaluation should be used to update current discharge planning guidance.
• In the next six months, publish guidance to clarify and strengthen the role of integration joint boards and health and social care partnerships in the governance and delivery of the health and social care service renewal framework.
• Over the next 12 months, provide guidance on, and better promote public awareness of the benefits of, establishing a power of attorney or a guardianship order.
• Over the next 12 months, work together to develop and action an implementation plan to share learning and practice from digital solutions used for tackling delayed discharges, early intervention and prevention,

Jointly, the Scottish Government and Public Health Scotland should:

• Produce a clear estimate of the total costs of delayed discharges and the savings being made through initiatives to reduce delayed discharges. This should be completed within the next 12 months, updated regularly and reported in the annual analysis of delayed discharge performance.