Chamber and committees

As discussed in answer to PQ S6W-34114 on 12 February 2025, the standard definitions of delayed discharge in use across NHS Scotland since 2016 do not identify patients as surgically fit for discharge, and the reasons for delayed discharge (when patients remain in hospital after being declared clinically ready for discharge) do not allow a direct count of patients who have refused to leave hospital.

All answers to written Parliamentary Questions are available on the Parliament’s website, the search facility for which can be found at https://www.parliament.scot/chamber-and-committees/written-questions-and-answers

Guidance for staff in relation to usage of IT is provided in the IT Code of Conduct, which sets out acceptable usage for Scottish Government devices and networks. It covers:

• personal use of SCOTS and the internet
• misuse of IT misconduct examples
• accidental access to restricted sites
• sharing sensitive data by email
• monitoring

The code aligns with the wide range of legislation to tackle the potential criminal and civil liability issues that may arise from colleagues’ misuse of communication facilities while at work.

Scottish Government has robust controls in place to identify any inappropriate use of devices. Sanctions for device misuse can range from warnings to loss of access and dismissal.

Scottish Government staff sign an agreement to adhere to the IT Code of Conduct. The IT Code of Conduct sets out guidance on the acceptable use of the official platform (SCOTS), in particular email and use of the intranet. The Code also outlines our policy on the personal use of Scottish Government IT facilities.

This is a matter for NHS boards and Police Scotland. The information requested is not held centrally.

Public Health Scotland publishes monthly Official Statistics on the number of people remaining in hospital after being declared ready for discharge, along with the reason for their delay. This information is recorded within each NHS board using a common set of definitions and codes applied across all NHS boards in Scotland.

Inpatients are determined clinically ready for discharge by the consultant/GP responsible for the inpatient medical care and where a multi-disciplinary team has agreed that the individual’s care needs can be further assessed or properly met outside a hospital setting. Clinical readiness is not synonymous with surgical fitness for discharge.

Refusal to leave hospital is not directly captured as a reason for delay in the common delayed discharge definitions.

Delayed discharges due to patients exercising their statutory right to choice of care home accommodation are captured under two reason codes:

• 71: Standard delays due to Patient exercising statutory right of choice, and
• 71x: Complex (Code 9) delays due to Patient exercising statutory right of choice where an interim placement is not possible or reasonable.

Patients recorded as delayed due to exercising their statutory right to choice (71 and 71x) should not be interpreted as refusing to leave hospital.

Codes 71 and 71x are used when a patient has exercised their right to their choice of residential care home, which is a statutory right under The Social Work (Scotland) Act 1968 (Choice of Accommodation) Directions 1993. This right is subject to provisions, including that the chosen accommodation will be available within a reasonable period, the provider is willing to provide accommodation and the cost to the local authority is not more than it would usually expect to pay.

The definitions further specify that code 71x: “…should only be used where long travel distances or limited transport infrastructures restrict the ability of families and friends to visit and where the placement may isolate the individual from a vital family and social network. This code should only be applied where remaining in a hospital setting is a more appropriate outcome and is the only viable alternative to an interim move. In all other choice cases (code 71) the underlying principle should be that remaining in hospital is not an option.”

Any patient who refuses to leave hospital for any other reason other than exercising their statutory right to choice of accommodation may be recorded as delayed due to “Other patient/carer/family-related reason”, however not all patients recorded with this reason code can be said to be refusing to leave hospital.

The Scottish Government retains logs of internet access by staff connected to the Scottish Government network for a period of 6 months only. There were zero connections made to websites categorised as "pornography" recorded in the last 6 months from any device connected to the Scottish Government network.

No-one should be the victim of abuse or violence while at work and assaults on NHS staff are completely unacceptable. We encourage Health Boards to support criminal proceedings, where appropriate, against anyone who assaults staff. NHSScotland staff can access a range of services to care for their physical and mental health. This includes employee assistance programmes, trauma counselling services and pastoral support, to ensure a safe working environment.

The wellbeing of our health and social care workforce remains a key priority and we are working to ensure that the right level of support is offered across the system. Scottish Government funding provides our workforce with access to psychological interventions and therapies, self-service resources through the National Wellbeing Hub and the National Wellbeing Helpline delivered by NHS 24 to support their wellbeing. We also provide access to confidential mental health services through the Workforce Specialist Service.

Public Health Scotland publish quarterly statistics on bed occupancy figures split by Health Boards. The publication does not contain information on occupancy by reason or deadline.

Bed occupancy release: Data summary - Acute hospital activity and NHS beds information (quarterly) - Quarter ending 30 June 2024 - Acute hospital activity and NHS beds information (quarterly) - Publications - Public Health Scotland

The Scottish Government holds unvalidated weekly management information on current acute staffed bed occupancy at NHS boards. The weekly collection does not provide data on the reason for occupancy. The management information is consistent with individual local definitions rather than national definitions and is difficult to compare with published statistics.

Public Health Scotland publish information on laboratory test results of Norovirus and flu hospital admissions. The publications do not include statistics on occupancy due to norovirus or flu.

Flu seasons with high levels of flu hospital admissions do impact negatively on health and care system flow.

Norovirus release: Laboratory reports of norovirus in Scotland - Up to week ending 2 February 2025 - Laboratory reports of norovirus in Scotland - Publications - Public Health Scotland

Flu release: Viral respiratory diseases (including influenza and COVID-19) in Scotland surveillance report 6 February 2025 - Viral respiratory diseases (including influenza and COVID-19) in Scotland surveillance report - Publications - Public Health Scotland

As discussed in answer to question S6W-34114 on 12 February 2025, the standard definitions of delayed discharge in use across NHS Scotland since 2016 do not identify patients as surgically fit for discharge, and the reasons for delayed discharge (when patients remain in hospital after being declared clinically ready for discharge) do not allow a direct count of patients who have refused to leave hospital.

As such, using the data we have at a national level it is not possible to analyse the impact of refusal to leave hospital on hospital capacity, and no such analysis has been undertaken.

All answers to written Parliamentary Questions are available on the Parliament’s website, the search facility for which can be found at https://www.parliament.scot/chamber-and-committees/written-questions-and-answers