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

Methodology and further information

Time period and scope 

The seventh Inpatient Census took place on April 12, 2023, conducted by the Scottish Government and NHS Boards. This is the sixth time data on HBCCC patients has been collected. 

The Census was divided into 3 parts: 

• Part 1: Included patients in psychiatric, addiction, or learning disability inpatient beds in NHS Scotland facilities on the Census date. 
• Part 2: Covered mental health, addiction, or learning disability patients funded by NHS Scotland but treated outwith NHS Scotland. 

• Part 3: Included patients receiving Hospital Based Complex Clinical Care (HBCCC) or Long Stay in general acute or community hospital inpatient beds on the Census date. 

The Census guidance notes are available on request. 

This report analyses patients with HBCCC or Long Stay status from Parts 1, 2, and 3 of the Census. Patients treated in the State Hospital are not included in this report.  

Data completeness 

All NHS Scotland boards with psychiatric, addiction, or learning disability inpatient beds provided data for Part 1. 

Data completeness varied for individual Census questions. Missing data is footnoted in tables or charts.

For patients treated outwith NHS Scotland (Part 2), boards with such patients provided returns. 

Hospital Based Complex Clinical Care (Part 3): 

All territorial NHS Boards with HBCCC or LS patients in general acute or community beds provided returns. 

Data collection 

The Scottish Government's Data Aquisition Unit provided secure data collection software and initial validation checks. 

Health & Social Care Analysis Division conducted second-stage validation checks. 

The data collection, analysis, and report were overseen by statisticians in the Government Statistical Service. 

Implementation of sex and transgender questions

In 2023 the questions used to collect data in this area were aligned with the Scottish Government, Office of the Chief Statistician’s guidance on sex, gender identity and trans status:

Sex, gender identity, trans status - data collection and publication: guidance - gov.scot (www.gov.scot)

This improved the language, design and consistency of the questions being used and has enabled people to be more appropriately represented in the survey.

The change to reporting of sex instead of gender and the introduction of extra questions here also brings the Censusvquestions into alignment with other Health and Social Care surveys such as the Scottish Health Survey, and the National Records of Scotland population census.

The change in the questions asked in the Mental Health Impatient Census is described below:

Prior to 2023 the following question was asked:

Q - Gender of patient:       

• Male
• Female
• Other
• [for coding only] Not known

From 2023 onwards, the following questions are now asked:

Q - Sex of patient:

• Female
• Male
• Prefer not to say
• [for coding only] Not known

Q - Does the patient consider themselves to be trans, or have a trans history?         

• Yes
• No
• Prefer not to say
• Not known

Q - If the patient would like to, how would they describe their trans status (for example, non-binary, trans man, trans woman)?

• Answer can be supplied as free text response.

This means that from 2023 onwards data on sex that is reported in the Census is not directly comparable with data collected on gender for prior years. Notes have been added to the relevant sections of the publication to make this clear.

The Census is one of the data collections that is part of the Equalities Data Improvement Programme (EDIP). The EDIP was a commitment to expand and make improvements to protected characteristics data. This was part of the wider Equality Evidence Strategy, published in March 2023. More details on this are provided here:

Scotland’s Equality Evidence Strategy 2023-2025 - gov.scot (www.gov.scot)

Plans for future Censuses

In 2025, as part of the EDIP commitments, we plan to expand the range of protected characteristics data collected.

It is also our intention in 2025 to run a consultation with the users of the Census to find out what content is most useful for users and to gather views on any changes users would like to see in the data collection and publication. We will post more information on our Census website as our planning for this develops.

Data confidentiality

A Data Protection Impact Assessment was conducted before the Census, outlining patient confidentiality. It can be obtained on request. 

Statistical disclosure control methods were used to protect confidential data where patient counts were below 5. Further information about Statistical Disclosure Control is available here: 

Statistical disclosure control - Office for National Statistics (ons.gov.uk) 

Access to data for research

Extracts of the Inpatient Census data may be available for approved researchers. 

Academic researchers should apply to the 'Statistics Public Benefit and Privacy Panel' for access to data. 

Approved applications and approval letters should be submitted for approval by the Scottish Government. 

Correspondence and enquiries 

For publication enquiries, contact Health & Social Care Analysis Division at the Scottish Government: mhic@gov.scot 

Health and Social Care Analysis (HSCA) builds the evidence base for Health and Care in Scotland, providing support for policy development and service planning.