Inpatient census 2018: parts one and two

Executive summary

This report presents an overview of the results of the fourth 'Mental Health & Learning Disability Inpatient Bed Census' and the 'Mental Health, Addiction and Learning Disability Patients: Out of NHS Scotland Placements Census', carried out by the Scottish Government and NHS Boards as at midnight, 28 March 2018 (please note: NHS Greater Glasgow & Clyde carried out their Census at midnight, 30 May 2018).

The report enhances the Scottish Government's and NHS Scotland's understanding of mental health, addiction and learning disability services, and the patients who use these services. This analytical evidence will inform policy development and service planning, both nationally and locally.

Number of patients occupying a psychiatric, addiction or learning disability inpatient bed in an NHS Scotland facility, by Census

Some key points from this report include:

• There were 3,443 patients occupying a psychiatric, addiction or learning disability inpatient bed in an NHS Scotland facility at 2018 Census, a 4% decrease on 2017.
• The most common mental health diagnosis in 2018 amongst adult inpatients was schizophrenia.
• Of the 3,443 patients, 58% were Male, 42% were female.
• The patients in the Census were mostly from older age groups, 24% were aged 18-39, 35% were aged 40-64 and 40% aged 65+.
• There were 51 patients aged under 18 occupying the 54 available CAMHS beds at the 2018 Census. In addition, 6 patients under 18 were staying in other wards.
• Patients were most likely to be in an Acute Ward (33% of all patients).
• As at the 2018 Census, there were 4,075 psychiatric, addiction or learning disability inpatient beds available in NHS Scotland, compared to 4,205 in 2017. The overall occupancy rate in Scotland was 84%.
• There were 39 patients "boarding" from another hospital. This is a hospital out with their local catchment area. Of these, 10 patients were boarding from a different health board.
• There were 475 patients primarily managed by forensic services in the 2018 Census. This compares with 484 in 2017. Forensic psychiatry is a specialised branch of clinical psychiatry which relates to mentally disordered offenders and others with similar problems.
• Of the 3,385 patients aged 18+ at the Census, 278 patients (8%) had a diagnosis for either a learning disability or autism. 220 patients had a diagnosis for a learning disability, 132 patients had a diagnosis for autism (74 patients had a diagnosis for both).
• Of the 3,443 patients occupying a psychiatric, addiction or learning disability inpatient bed at the 2018 Census, 731 received Hospital Based Complex Clinical Care (HBCCC). This is 21% of all patients. HBCCC by definition does not include Delayed Discharge patients.
• There were 258 patients who were a delayed discharge at the Census, 8% of all patient for which this information was known (data was incomplete for 50 patients). Delayed discharge patients are clinically ready for discharge but cannot leave hospital because the necessary care, support or accommodation is not yet available.
• Most patients (60%) aged 18+ had at least one long term physical health co-morbidity.
• 1,875 adult patients were either Overweight or Obese (excluding patients in Eating Disorder wards). This is 58% for whom BMI was known.
• 93% of adult patients admitted in the last year had a general physical exam within a day of admission and 91% of those admitted over a year ago had an annual physical exam.
• There were an additional 197 patients who were funded by NHS Scotland, but treated "outwith" NHS Scotland, either in a private facility or NHS facility elsewhere in the UK. This compares with 109 patients at the 2017 Census.
• Length of stay varied greatly by ward type. Patients in acute wards had an average (median) stay of 36 days, while patients in forensic (learning disability) wards had an average stay of over 3 years.