Delayed Discharge Costs NHS Scotland £440m A Year
Thousands of medically fit patients remained in hospital beds for an additional 720,000 days during 2024-25 due to delayed discharge arrangements, according to healthcare regulators.
The problem, which results when patients ready to leave hospital cannot be transferred to appropriate care settings, reflects mounting strain across both health and social care systems, and affects people’s physical and mental health, and make it harder to admit others to hospital the regulators said.
These avoidable hospital stays are estimated to cost approximately £440 million annually, though the complete economic impact remains uncertain. Despite various initiatives aimed at addressing the crisis, limited assessment of their effectiveness means it is unclear which interventions are proving most successful or whether they represent good value for taxpayers.
A 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.
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 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, 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.”
Welcoming the report, geriatrician Professor Andrew Elder, president of the Royal College of Physicians of Edinburgh, said the long-standing problem has intensified:
“Delayed discharges have existed in the NHS in Scotland for decades, pre-dating the current government’s tenure, but have become more visible in our acute hospitals as the capacity in ‘downstream’ non-acute NHS facilities has been progressively reduced. The ageing of our population is a societal triumph, but our failure to provide integrated health and social care for that population risks turning that triumph into a disaster.”
