The Ferret contacted all 12 NHS health boards who provided figures showing delayed discharges from mental health wards and eight responded.

Here are their responses in full.

NHS Greater Glasgow and Clyde:

“In NHSGGC we recognise that a small number of patients who have complex mental and physical health needs may experience delays in being discharged from hospital to appropriate packages of community care.

Some delays may be incurred in an effort to match and tailor a person's needs to the extensive variety of community care options available, ensuring that each individual has the best prospect of a successful and sustained discharge from hospital. 

 We continue to work closely and collaboratively with our partners in our Health and Social Care Partnerships to prioritise this and ensure smooth discharge from hospital to suitable services in the local community which meet the needs of each patient.”

NHS Borders

“NHS Borders as a whole, including the Mental Health Service, have a particular focus on ensuring timely discharge from hospital as soon as a patient is viewed by the medical team as ready for discharge home.  Our intention is to begin discussions with the patient and family about the process and options for discharge as soon as appropriate following admission.

“Our mental health team often have to work through additional complex stages as part of patient discharge which can take time. This includes legal framework where patients may lack capacity and addressing the very difficult decisions to support a patient into a suitable care home if going home is not appropriate.

“We have invested in a specialist team to support care homes and our Community hospitals to best care for patients in a community setting where appropriate. We have also employed an additional social worker to work with patients and families to promote effective discharge plans and we continue to look at ways to reduce delayed discharges wherever possible.”

Forth Valley

“When a patient leaves hospital it is vital that they get the right care to meet their individual needs. 

Some specialist facilities may not have the availability to accommodate them and they may need to be placed on a waiting list.

 Where possible, we try to place an individual as near to their home as we can to help their transition from hospital.”

The Ferret Investigation:

Part 1:  Scotland's mental health patients face three-year discharge delays — despite being well enough to leave

Part 2: Community treatment calls as three-year mental health ward discharge delays laid bare

Lanarkshire

Ross McGuffie, chief officer, Health & Social Care North Lanarkshire, said: “Reducing delayed discharges is one of our key priorities and we are continuing to take steps to make improvements in this area.

“We are rolling out a planned date of discharge initiative to provide patients with a realistic but flexible timescale for discharge. As soon as someone is admitted, their projected length of stay is discussed by the multi-disciplined team as a way of proactively working towards discharge as soon as it is clinically appropriate to do so.

“This initiative is front and centre of all multi-disciplinary discussions and is discussed at every multi-disciplinary team review.

“Unfortunately, the external processes around care home placements and guardianship have been subject to significant delays during Covid, resulting in a prolonged length of stay for a small number of patients.

“In NHS Lanarkshire, we have a dedicated team of discharge liaison nurses who manage these processes proactively and link in with partner organisations to minimise delays.”

Tayside

A spokesperson for NHS Tayside said, “Discharge from inpatient mental health specialities, which include general adult psychiatry, psychiatry of old age and learning disability services, can be delayed for a number of reasons.  

“This includes when waiting for admission to care homes, social care assessment, provision of equipment or care at home services, specialist care and treatment outwith the local Board area and housing solutions for people with complex care requirements. 

“There are particular challenges within our learning disability inpatient services where patients may experience lengthy delays due to highly complex health and care needs. 

“The effective management of delayed discharges is also a priority for each of the Health and Social Care Partnerships in the NHS Tayside area and collaborative working takes place across mental health and social care services to promote current community service provision and future care requirements to ensure support and timely discharge from hospital.” 

Grampian

An NHS Grampian spokeswoman said: "Delayed discharges are frustrating for both patient and clinical team alike. It is always our preference to see people cared for in the most appropriate setting. The majority of patients do progress from in-patient care to other settings in good time, and excessively delayed discharges remain the exception, rather than the norm. Some of the people in the care of the Mental Health & Learning Disability Service have complex needs and need very specialist support. Accessing this care can take time and requires a number of agencies to work together. Rather than cause unnecessary distress with multiple changes in where that care is provided, we seek to take a person-centred approach. This provides continuity of care and sees discharge supported when an individual is able to move on to the best setting for them."

Ayrshire and Arran 

Caroline Cameron, North Ayrshire Health and Social Care Partnership Director said: “The appropriate discharge of individuals with ongoing mental health needs is complex. It requires patients to have the appropriate supported community care, particularly for those individuals who don’t need continued hospital care, but still require support in the community.  

“In some circumstances, individuals require to be supported in their own homes and require shared care in supported accommodation/housing where they would be supported to independently live in the community by core staff available to meet their needs.   Spaces are currently not always available at the time these individuals are fit for discharge, and many delays are due to this wait for appropriate accommodation.

“There are a number of supported accommodation housing developments across Ayrshire and Arran, with a number of new developments being brought online to specifically to address the current gap in available accommodation for these patients and other individuals in the community requiring this level of support. 

“There can also be lengthy delays where individuals do not have the legal capacity to make decisions about their care, for example where a private guardianship is being progressed. Less often, some delays also relate to identifying an appropriate care provider to deliver care or having funding identified for significant packages of care, for example where a 2:1 package of support is required.  

“The Scottish Government outlined an ambition to invest across Scotland in the re-design of services for people with complex care needs including enduring mental health problems, which would include the discharge of those that have encountered lengthy hospital stays.  In line with this, a Community Living Change Fund of £20m has been allocated to IJBs across Scotland to plan alongside housing colleagues for investment in further community alternatives, this further investment will complement the programme of supported accommodation already underway to ensure that community alternatives are more readily available.”

NHS Highland

“There are a variety of reasons for delayed discharges. However, the most frequent one is a delay in finding suitable onward placement or accommodation.  We always aim to ensure that our patients are discharged to the right place to safely meet their unique needs and achieving this can take time past when they would otherwise be ready to leave the hospital.”

NHS Lothian did not provide the data requested. It told The Ferret: 

“We are very sorry but it appears that there has been a misunderstanding in the data that was supplied and the data that you are actually looking for. Our response to your original FOI request focused around medically fit dates, not delayed discharges. 
“To count as a delayed discharge social work have to be involved.  Medically fit dates also include patients who may be moved onto another healthcare setting for continuing care.  As such, the figures quoted for being medically fit do not necessarily translate into a delayed discharged and it would be incorrect to quote those figures. We apologise if we misunderstood what you were asking the first time around. 

“We are happy to look at this further, but it will need to be set out clearly in an FOI requesting the data for ‘delayed discharges’ so that they team can investigate and verify this set of data.”