Argyll & Bute CHP Committee
Date of Meeting: 6 March 2009
Item Number: 10.3
Delayed Discharge Report
Report by Josephine Bown, Head of Service Integration
1. / BackgroundThe Scottish Government established targets for reducing the number of delayed discharges waiting more than 6 weeks and those in Short-Stay beds.
It was expected that by the beginning of April 2008 all Partnerships would achieve a zero return. The Argyll & Bute Partnership achieved the target.
Following April we continue to monitor and report on all Delayed Discharges.
At time of reporting the situation is as follows (February 2009);
1 / Delayed Discharges over 6 weeks
4 / Delayed Discharges in Short-Stay beds
9 / Delayed Discharges coded 9/51x (AWI)
0 / Delayed Discharges coded 9/71x (Exemption)
2. / Update
2.1 / Target Breaches
There is one delayed discharge over 6 weeks, this patient is in CampbeltownHospital.
The family have appealed on 2 occasions (unsuccessfully) against the reasons for discharge.
The Locality Manager is making arrangements for discharge and this will entail a letter being sent by the Chief Executive to the patient/family. This process needs to be managed sensitively and diplomatically and this out of necessity takes time.
There were 4 delayed discharges in short-stay beds in Lorn & Islands DGH;
- 3 have been discharged
- 1 remains in hospital
2.2 / Exemptions
There are no 9/71X cases this month. The attached table demonstrates the situation over the last year, by month.
There was a steady increase in number from March 08 (7 cases) to a high (15 cases) in July and August, which then declined to 3 in January 09 and zero in the current reporting month (February).
Conversely we are seeing a different picture in the number of 9/51X (AWI). The number of which are now at a high of 9, whereas in March 08 this figure was 3.
The distribution of the 9 cases is presently across 4 hospitals.
This situation is being investigated by the Service Manager – Operations and Service Manager – Mental Health (Argyll & Bute Council).
3. / Governance implications
- Staff – None identified
- Patient focus and Public Involvement – Of interest to local communities
- Clinical Governance – The Partnership has an agreed model of care and the planning of care packages for all delayed discharge cases fits with this model. However there is a need for all practitioners to initially consider for every case that discharge home is the preferred option, and should be actively planned for, sometimes this requires a higher threshold for risk management.
- Financial – Delayed Discharges and a high number of emergency admissions of older people result in pressure on in-patient beds required for acute care provision.
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Argyll & Bute CHP Committee
Date of Meeting: 6 March 2009
Item Number: 10.3
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