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Publication - Statistics

Mental Health Inpatient Census 2023 Part 3: hospital-based complex clinical care and long stay

Published
5 November 2024
Directorate
Population Health Directorate
Topic
Health and social care

Results from the Hospital Based Complex Clinical Care (HBCCC) and Long Stay Census, carried out in April 2023. The data was collected as part of the Inpatient Census.

Supporting documents

Number of HBCCC and Long Stay Patients in Census 

In the 2023 Census, a total of 1,323 patients were classified as Hospital Based Complex Clinical Care (HBCCC) or Long Stay patients. Out of these, 637 (48%) were receiving HBCCC, and 686 (52%) were Long Stay patients. Long Stay refers to patients in the hospital for at least 6 months with no delayed discharge date but not receiving HBCCC. 

Of these 1,323 patients, 1,066 (81%) were in Mental Health, Learning Disability, or Addiction Inpatient Beds in NHS Scotland facilities. 137 (10%) were in General Acute / Community Hospital NHS Scotland facilities. 120 (9%) were treated outwith but funded by NHS Scotland (e.g., private hospitals or non-NHS Scotland UK facilities). There are also a very small number of patients treated within NHS Scotland but funded externally. 

Please note: The numbers provided in this publication for HBCCC patients may not match those in the Mental Health Inpatient Census parts 1 & 2. This is because in Parts 1 & 2, only HBCCC patients with mental health diagnoses are considered. In Part 3, all HBCCC patients are included in the figures. 

Table 1: Number of HBCCC and long-stay patients by Census part, 2022 – 2023

Mental health Inpatient Census and HBCCC Census, Scotland 2022-2023.

Inpatient Census All Patients   HBCCC Patients   long-stay Patients  
 

2022

2023

2022

2023

2022

2023

Part 1: Mental Health Bed Census

949

1,066

409

508

540

558

Part 2: Outwith NHS Scotland Placements

158

120

86

50

72

70

Part 3: HBCCC & LS (general acute)

143

137

80

79

63

58

All HBCCC patients in Inpatient Census

1,250

1,323

575

637

675

686

Age and sex 

Figure 2 shows the age and sex breakdown of patients receiving HBCCC at the 2023 Census. Some key points include:

  • for HBCCC patients, 372 (58%) were male and 265 (42%) were female. 
  • a majority of HBCCC patients, 361 (57%), were aged 65 or over, a decrease from 61% in 2022. 
  • 174 (27%) were aged 40 - 64, and 88 (14%) were aged 18 - 39. 

Figure 2: Males make up the majority of HBCCC patients with female patients becoming more prevalent with age.

Mental health Inpatient Census and HBCCC Census, Scotland 2023.

Figure 2: There were 177 female and 184 male HBCCC patients aged 65 and over, 60 female and 114 male HBCCC patients aged between 40 and 64 and 28 female and 74 male HBCCC patients aged between 0 and 39.

Figure 3 shows the age and sex breakdown of long-stay patients at the 2023 Census. Some key points include:

  • for Long Stay patients, 413 (60%) were male, and 273 (40%) were female. 
  • most Long Stay patients, 288 (42%), were aged 40 – 64.
  • 169 (25%) were aged 65 or over, and 229 (33%) were under 40 at the 2023 Census. 

Figure 3: Males make up the majority of long-stay patients.

Mental health Inpatient Census and HBCCC Census, Scotland 2023.

Figure 3: Males make up the majority of LS patients. There were 81 female and 88 male LS patients aged 65 and over, 117 female and 171 male LS patients aged between 40 and 64, and 75 female and 154 male LS patients aged between 0 and 39.

Ethnicity 

At the 2023 Census, the majority of HBCCC or Long Stay patients described themselves as White Scottish (68%). An additional 14% were of another White ethnicity, while information was not known or refused for 11% of patients. 

Figure 4: HBCCC or long-stay patients are overwhelmingly of White Scottish ethnicity where reported.

Mental health Inpatient Census and HBCCC Census, Scotland 2023.

Figure 4: HBCCC or LS patients are overwhelmingly of White Scottish ethnicity (893 patients) where reported. The HBCCC or LS patients who were of another White ethnicity included mostly White Other British patients (89), there were also 23 patients who described themselves as being of Asian, Asian Scottish or Asian British ethnicity.

 

* Data was missing or refused for 199 patients.

** Numbers less than 5 have been suppressed to protect data confidentiality

Consultant Specialty 

Of the 637 patients receiving HBCCC at the 2023 Census, 262 (41%) had a consultant specialising in Psychiatry of Old Age. 133 patients (21%) had a consultant in General Psychiatry, and 86 (14%) in Geriatric Medicine. 

Figure 5: The largest group of HBCCC patients are treated in Psychiatric specialties.

Mental health Inpatient Census and HBCCC Census, Scotland 2023.

Figure 5: The largest group of HBCCC patients are treated in Psychiatric specialties. There were also 50 HBCCC patients who had a consultant that specialised outwith NHS Scotland, 51 patients who had a consultant that specialised in geriatric medicine, and 88 patients in forensic psychiatry, 1 patient was not known and 24 patients in other.

 

*Other includes a range of specialties with small numbers of patients that have been aggregated to protect patient confidentiality.

** Data is unknown for 1 patient.

For the 686 Long Stay patients at the Census, 281 (41%) had a consultant in General Psychiatry, 137 (20%) in Forensic Psychiatry, and 99 (14%) in Psychiatry of Old Age. 

Figure 6: The largest group of long-stay patients are treated in Psychiatric specialties

Mental health Inpatient Census and HBCCC Census, Scotland 2023.

Figure 6: The largest group of LS patients are treated in Psychiatric specialties. There were also 70 LS patients who had a consultant that specialised outwith NHS Scotland, 27 patients had a consultant that specialised in learning disability, 22 patients in geriatric medicine, 14 patients in rehabilitation medicine, 17 patients were not know and 19 patients in other.

* Other includes a range of specialties with small numbers of patients that have been aggregated to protect patient confidentiality.

** Data is unknown for 17 patients.

NHS Board Breakdown 

NHS Greater Glasgow & Clyde funded 31% of HBCCC patients, followed by NHS Lothian with 26%. 

Figure 7: NHS Greater Glasgow & Clyde fund the largest number of HBCCC patients

Mental health Inpatient Census and HBCCC Census, Scotland 2023.

Figure 7: NHS Greater Glasgow & Clyde fund the largest number of HBCCC patients. NHS Lothian were responsible for funding the treatment of 168 HBCCC patients, NHS Lanarkshire funded the treatment of 74 HBCCC patients, NHS Ayrshire & Arran funded 30 patients, NHS Tayside funded 60 patients, NHS Grampian funded 55 patients, NHS Fife funded 21 patients, NHS Forth Valley funded 13 patients, NHS Highland funded 10 patients and ‘other’ funded 8 patients.

 

* Other includes Boards where numbers were too small to present individually.

** National Services Division is funded by the territorial NHS Boards, and provides funding for a small number of patients in cases where they may require more specialised, long-term or cost-intensive treatment.

NHS Lothian had the highest rate of HBCCC patients at 18.3 per 100,000 population. This is a slight increase from the 16.4 patients per 100,000 population funded by NHS Lothian at the 2022 Census.

Figure 8: NHS Lothian fund the highest rate of HBCCC patients per 100,000 population

Mental health Inpatient Census and HBCCC Census, Scotland 2023.

Figure 8: NHS Lothian fund the highest rate of HBCCC patients per 100,000 population. NHS Greater Glasgow & Clyde funded 16.7 per 100,000, NHS Lanarkshire funded 11.1 per 100,000 population, NHS Tayside 14.4 per 100,000, NHS Western Isles 3.8 per 100,000, NHS Grampian 9.4 per 100,000, NHS Ayrshire & Arran 8.1 per 100,000, NHS Fife 5.6 per 100,000 and NHS Highlands 3 per 100,000.

*Excludes Health Boards with numbers less than 10 to protect data confidentiality.

NHS Greater Glasgow & Clyde were responsible for funding the treatment of 207 long-stay patients (30%). The proportion of long-stay patients funded by NHS Greater Glasgow & Clyde is four percentage points higher than in 2022. NHS Lothian funded the next highest number of long-stay patients with 125 (18%). 

Figure 9: NHS Greater Glasgow & Clyde fund the largest number of long-stay patients

Mental health Inpatient Census and HBCCC Census, Scotland 2023.

Figure 9: NHS Greater Glasgow & Clyde fund the largest number of LS patients at 216. NHS Grampian were responsible for funding the treatment of 55 LS patients, NHS Lothian funded 136 patients, NHS Highland funded 41 patients, NHS Lanarkshire funded 39 patients, NHS Ayrshire & Arran funded 42 patients, NHS Fife funded 67 patients, NHS Forth valley funded 27 patients, NHS Dumfries and Galloway funded 14 patients, NHS Tayside funded 42 patients. 6 patients were funded by other health boards.

*Information was unknown for 2 patients

**Other includes Boards where numbers were too small to present individually

NHS Fife had the highest funding rate for long stay patients at 18.7 per 100,000 population. NHS Greater Glasgow & Clyde funded the next highest rate at 17.5 per 100,000 population. 

Figure 10: NHS Fife fund the highest rate of long-stay patients per 100,000 population.

Mental health Inpatient Census and HBCCC Census, Scotland 2023.

Figure 10: NHS Fife fund the highest rate of LS patients per 100,000 population. NHS Glasgow and Clyde had a funding rate for LS patients at 17.5 per 100,000 population, NHS Highland 12.6 per 100,000, NHS Dumfries & Galloway 11.4 per 100,000, NHS Borders 5.2 per 100,000, NHS Grampian 9.9 per 100,000, NHS Ayrshire & Arran 11.4 per 100,000, NHS Forth Valley 8.5 per 100,000 and NHS Lanarkshire 7.9 per 100,000, NHS Tayside 9.8 per 100,000.

*Excludes Health Boards with numbers less than 10 to protect data confidentiality.

Local Authority Breakdown

Figure 11 and 12 provides analysis of patients in receipt of HBCCC and LS by Local Authority of residence. This is based on the patient’s home postcode. City of Edinburgh had the most HBCCC patients at 16%, while Glasgow City had the most Long Stay patients at 22%.

Figure 11: The City of Edinburgh had the highest number of HBCCC patients by home postcode.

Mental health Inpatient Census and HBCCC Census, Scotland 2023.

Figure 11: The City of Edinburgh has the largest number of HBCCC patients by home postcode. Glasgow City had the second most with 77 patients. North Lanarkshire and Renfrewshire had the third largest number of HBCCC patients by home postcode with 54, followed by Renfrewshire with 55 patients. West Lothian had 45 patients, Inverclyde had 34 patients and Aberdeen City had 30 patients. The remainder of areas had between 23 and 6 patients.

* Other includes Local Authorities where numbers were too small to present individually

** Information was unknown for 27 patients

Figure 12: Glasgow City has the largest number of long-stay patients by home postcode.

Mental health Inpatient Census and HBCCC Census, Scotland 2023.

Figure 12: Glasgow City has the largest number of LS patients by home postcode. City of Edinburgh had the second largest number of LS patients by home postcode with 91 patients, followed by Fife with 63 patients. The remainder of areas had between 34 and 7 patients.

* Other includes Local Authorities where numbers were too small to present individually

** Information was unknown for 31 patients

Length of Stay 

Average time in hospital for HBCCC patients was approximately 1 year and 5 months. For Long Stay patients, the average time in hospital was approximately 1 year and 4 months. Average HBCCC and Long-stay stays are longer than reported at 2022 Census.

Table 2: Length of Stay, HBCCC and long-stay patients, 2022 - 2023

Mental health Inpatient Census and HBCCC Census, Scotland 2022 - 2023.

Length of Stay HBCCC Patients   Long-stay Patients  
 

2022

2023

2022

2023

Less than 6 months

147

160

-

-

At least 6 months, less than 1 year

129

92

251

245

At least 1 year, less than 3 years

256

206

288

242

At least 3 year, less than 5 years

111

64

76

71

5 years or more

152

115

131

128

Median

498

517

658

500

Health Conditions 

NHS Boards were asked to return information on any health conditions a patient had been diagnosed with. Mental Health conditions were the most prevalent for both HBCCC (62%) and Long Stay patients (75%) in the 2023 Census. 

Figure 13: Mental Health conditions are the most common diagnoses among HBCCC patients

Mental health Inpatient Census and HBCCC Census, Scotland 2023.

Figure 13: Mental Health conditions are the most common diagnoses among HBCCC patients. 560 HBCCC patients had been diagnosed with a mental health condition, 33 HBCCC patients diagnosed with an nervous system condition, 67 HBCCC patients diagnosed with a circulatory condition, 35 HBCCC patients diagnosed with a musculoskeletal condition, 29 HBCCC diagnosed with a respiratory condition, 47 HBCCC diagnosed with a endocrine condition.

*Only includes most prevalent conditions

**Patients can have more than one condition

Figure 14: Mental Health conditions are the most common diagnoses among long-stay patients

Mental health Inpatient Census and HBCCC Census, Scotland 2023.

Figure 14: Mental Health conditions are the most common diagnoses among LS patients. 616 LS patients had been diagnosed with a mental health condition, 23 LS patients diagnosed with an nervous system condition, 32 LS patients diagnosed with a circulatory condition, 21 LS patients diagnosed with an abnormal clinical condition, 23 HBCCC diagnosed with a respiratory condition, 33 LS diagnosed with a endocrine condition.

 

*Only includes most prevalent conditions

**Patients can have more than one condition

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