Delayed discharges, a sign of wider challenges in health and social care
by Bill Heaney
Delays in discharging patients from hospital affect people’s physical and mental health, and make it harder to admit others to hospital. Delayed discharges are a symptom of wider pressures across health and social care in West Dunbartonshire and Argyll and Bute.
A joint report covering the whole country 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.
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.
The causes are complex, including rising demand for health and social care services, financial pressures, long-standing recruitment and retention problems across Scotland and for some, not having a Power of Attorney in place.
Reducing delayed discharges – it was initially called bed blocking and blamed on patients – is a priority for the Scottish Government and their partners in health and social care, with significant activity underway to tackle this. But a lack of evaluation of initiatives across the country means it is difficult to measure what is having the greatest impact and whether these initiatives represent value for the money and time spent.
Stephen Boyle, right, Auditor General for Scotland, said: ‘Delayed discharges from hospital have far-reaching impacts on people’s health and well-being. The Scottish Government, health bodies, councils and other partner organisations agree on the need for major changes and are actively trying to reduce delayed discharges.
‘Now they must improve how they collect, analyse and use data to evaluate the initiatives underway to tackle the problem. Without this, it’s impossible to understand the impacts and costs of delayed discharges and whether the initiatives across Scotland are improving lives, services and delivering value for money.’
Malcolm Bell, member of the Accounts Commission, said: ‘Significant change is critical across our health and social care services, shifting towards preventative care, greater use of technology and ongoing investment in the workforce. Without this, the care and support individuals need to leave hospital won’t always be available.
‘The Scottish Government and COSLA’s joint health and social care service renewal framework is an opportunity for progress to be made with health and social care reform. But IJBs and social care need to be at the centre of planning and decision-making on service renewal, and it’s not clear how the framework will address the challenges faced by social care.’
Labour health spokesperson Jackie Baillie and LibDem’s leader Alex Cole-Hamilton.
Scottish Labour health spokesperson and Dumbarton MSP Jackie Baillie MSP said: “The SNP once promised to end delayed discharge, but things are worse than ever before.
“It is staggering that 720,000 days were spent unnecessarily by patients in hospitals during 2024/25, with Audit Scotland estimating that this is costing the NHS around £440 million a year.
“This issue is causing misery for patients, piling pressure onto hospitals, and costing our NHS billions.
“The SNP’s lack of funding for social care, estimated at almost a £500million shortfall, is making matters worse as local Health & Social Care Partnerships are unable to meet demand and are cutting services.
“Yet, this incompetent SNP government has no answers, despite being in power for 19 years and claiming that the health service has turned a corner.
“We have previously called for the Scottish Government to make greater use of technology and to invest in the health and social care workforce, yet SNP ministers are failing to take any responsibility.
“Scottish Labour will step up and tackle this issue once and for all, by properly supporting social care and delivering the care packages that people need.”
Responding to the public spending watchdog reporting that delayed discharges cost the NHS alone at least £440 million a year, with the full cost to the health and social care system likely to be much higher, only the SNP Government no longer calculate it, Scottish Liberal Democrat leader Alex Cole-Hamilton MSP said.
He added: “It is utterly astonishing that our NHS is losing £1.2 million a day to delayed discharge under the SNP. These are people who should be cared for in the community at a quarter of the cost.
“The SNP’s abject failure to provide proper care at home or in the community is leaving 2,000 patients stuck in hospital on a typical night. It’s why A&E departments are struggling to move people into hospital and why ambulances are stacking up outside.
“By backing Scottish Liberal Democrats on your second, peach ballot paper in May, you can vote for a realistic plan to fix social care, so that we can fix the NHS.
“As the party of social care, we would create a new UK-wide minimum wage for care workers, £2 higher than the national minimum wage, to tackle the chronic staff shortages and make caring a profession of choice.”