Adults with Incapacity - delayed discharge: good practice guidance September 2023

1. Adults with Incapacity (AWI)

Good practice guidance to support adults discharged from hospital

Delayed discharges continue to present huge challenges across the country. Every patient who is medically fit to leave hospital should be able to do so. The Scottish Government is committed to working closely with local delivery partners to reduce delayed discharges. Scottish Government has set Health and Social Care Partnerships (HSCPs) targets to bring delayed discharge numbers down to pre-pandemic levels.

This guidance aims to provide HSCPs models of good practice to support a reduction in delayed discharges where adults lack capacity. This should be read in conjunction with the guidance issued jointly last year by the Scottish Government and the Mental Welfare Commission (MWC) as well as the Scottish Government key actions guidance.

Over winter 2022 to 2023 we met with the majority of HSCPs across Scotland to learn about the pressures in any given area and good practices that had been developed. These good practices are shared in this guidance in the hope they can support change and improvement in other areas.

The meetings followed a format of questions as follows:

• Can you tell us of any good practice that you can share with us at present?
• Can you tell us of any challenges that you are experiencing?
• How do you enact section 13ZA of the Social Work (Scotland) Act 1968?
• Are you experiencing any issues with the Court system?
• What is the balance between local authority and private guardianship applications?
• Have you issues with Mental Health Officer (MHO) recruitment and retention and senior practitioner status?
• Have you got links with local solicitors who will act in private Guardianship applications?
• Do you have systems in place to supervise the progress of private guardianship applications?
• Have you had issues with Legal Aid applications adding to delays
• Are there difficulties obtaining medical reports?
• Are Interim Orders being progressed?
• Is there involvement in Power of Attorney campaigns?
• What do you have in place to provide Supported Decision making?

From asking these questions we were able to identify particular pressures in each area and examples of good practice that improved performance.