Chamber and committees

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

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.

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I refer the member to the answer to question S6W-34097 on 12 February 2025. 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

I refer the member to the answer to question S6W-34097 on 12 February 2025. 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

I refer the member to the answer to question S6W-34097 on 12 February 2025. 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

Details are as follows:

I refer the member to the answer to question S6W-34097 on 12 February 2025. 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

Details are as follows: