Mental Health Inpatient Census 2023 - Parts 1 and 2
Results of the seventh Mental Health and Learning Disability Inpatient Census and Outwith NHS Scotland Placements Census, 2023.
Overview of patients being treated in NHS Scotland facilities
- There were 3,058 mental health, addiction and learning disability inpatients in NHS Scotland at the 2023 Census.
- Bed occupancy in NHS Scotland was 89%, with a wide range across individual NHS Boards.
- 11% out of all patients for whom this data was available experienced delayed discharge, with an average (median) delay of just under 3 months.
Inpatient Numbers
There were 3,058 inpatients in NHS Scotland on the census date in 2023, a 3% increase from 2022 and a 22% decrease from 2014. Variation exists across NHS Boards, but all have fewer patients in 2023 compared to 2014 (Table 1).
Table 1: Number of patients in psychiatric, addiction or learning disability beds.
Psychiatric, addiction or learning disability inpatients, NHS Scotland, March/April Census 2014 – 2023.
|
NHS Board of treatment |
2014* |
2016* |
2017* |
2018 |
2019* |
2022 |
2023 |
|
NHS Ayrshire & Arran |
198 |
184 |
192 |
201 |
184 |
166 |
170 |
|
NHS Borders |
59 |
45 |
50 |
53 |
c |
c |
c |
|
NHS Dumfries & Galloway |
77 |
49 |
55 |
55 |
65 |
68 |
76 |
|
NHS Fife |
256 |
184 |
253 |
238 |
234 |
186 |
216 |
|
NHS Forth Valley |
217 |
206 |
214 |
210 |
167 |
171 |
162 |
|
NHS Grampian |
339 |
319 |
297 |
291 |
272 |
233 |
262 |
|
NHS Greater Glasgow & Clyde |
1,105 |
1,111 |
1,002 |
937 |
984 |
903 |
933 |
|
NHS Highland |
169 |
173 |
160 |
141 |
132 |
105 |
108 |
|
NHS Lanarkshire |
346 |
312 |
301 |
269 |
284 |
181 |
210 |
|
NHS Lothian |
670 |
596 |
611 |
603 |
558 |
492 |
475 |
|
NHS Tayside |
334 |
322 |
312 |
325 |
274 |
304 |
296 |
|
NHS Western Isles |
18 |
15 |
14 |
12 |
c |
c |
c |
|
State Hospital |
121 |
117 |
111 |
108 |
109 |
113 |
109 |
|
NHS Scotland |
3,909 |
3,633 |
3,572 |
3,443 |
3,310 |
2,959 |
3,058 |
* These years are missing some hospital wards and figures are approximate.
** c - Suppressed due to small numbers, secondary suppression also applied
Please note that NHS Grampian, NHS Greater Glasgow & Clyde, NHS Lothian, and NHS Tayside have Regional Units that serve patients from other NHS Boards. NHS Fife also has a low security Learning Disability Regional Unit for patients from other boards. However, NHS Orkney and NHS Shetland do not have any mental health, learning disability, or addiction inpatient beds. Instead, their patients receive treatment from other health boards or healthcare providers.Available Beds
There were 3,436 available beds in NHS Scotland in 2023, less than 1% decrease from 2022 and a 19% decrease from 2014.
Table 2: Number of psychiatric, addiction or learning disability beds.
Psychiatric, addiction or learning disability inpatients, beds and occupancy rates, NHS Scotland, March/April Census 2014 – 2023.
| NHS Board | 2014* | 2016* | 2017* | 2018 | 2019* | 2022 | 2023 |
| NHS Ayrshire & Arran | 299 | 265 | 273 | 264 | 225 | 193 | 188 |
| NHS Borders | 65 | 57 | 63 | 63 | c | 49 | 42 |
| NHS Dumfries & Galloway | 107 | 85 | 85 | 85 | 85 | 81 | 81 |
| NHS Fife | 346 | 252 | 289 | 286 | 287 | 225 | 243 |
| NHS Forth Valley | 240 | 249 | 251 | 248 | 213 | 198 | 194 |
| NHS Grampian | 383 | 367 | 353 | 351 | 314 | 273 | 277 |
| NHS Greater Glasgow & Clyde | 1,176 | 1,154 | 1,128 | 1,061 | 1,054 | 1,030 | 1,048 |
| NHS Highland | 195 | 189 | 174 | 173 | 165 | 108 | 138 |
| NHS Lanarkshire | 450 | 440 | 411 | 393 | 411 | 269 | 269 |
| NHS Lothian | 711 | 645 | 649 | 639 | 623 | 571 | 510 |
| NHS Tayside | 409 | 402 | 380 | 379 | 357 | 329 | 321 |
| NHS Western Isles | 19 | 17 | 17 | 13 | c | 5 | 5 |
| State Hospital | 132 | 132 | 132 | 120 | 120 | 120 | 120 |
| Scotland | 4,532 | 4,254 | 4,205 | 4,075 | 3,922 | 3,451 | 3,436 |
* These years are missing some hospital wards and figures are approximate.
The decrease in available mental health beds is a trend seen in other European countries as well. For instance, OECD data shows that psychiatric beds for the UK as a whole declined from 46 per 100,000 people in 2014 to 35 per 100,000 in 2022. However the data is incomplete for some years and countries, and there may also be variations in methodologies between the nations. It is therefore important to exercise caution when interpreting the data.
Table 3: Available beds and inpatients per 100,000 population in NHS Scotland, 2014 – 2023
Psychiatric, addiction or learning disability inpatients, beds and occupancy rates, NHS Scotland, March/April Census 2014 – 2023.
|
Measure |
2014* |
2016* |
2017* |
2018 |
2019* |
2022 |
2023 |
|
Beds per 100,000 population |
84.7 |
78.7 |
77.5 |
74.9 |
71.8 |
63.0 |
62.7 |
|
Patients per 100,000 population |
73.1 |
67.2 |
65.8 |
63.3 |
60.6 |
54.0 |
55.8 |
* These years are missing some hospital wards and figures are approximate.
Bed Occupancy
The national occupancy rate of psychiatric, addiction, or learning disability beds in NHS Scotland at the 2023 Census was 89%. This is three percentage points higher than in 2022.
Since the first Census in 2014, occupancy rates have varied between 84% and 89%. However, there is a much larger variation in occupancy rates between different NHS Boards (Table 4).
Table 4: Occupancy rates for psychiatric, addiction or learning disability beds in NHS Scotland, 2014 – 2023
Psychiatric, addiction or learning disability inpatients, beds and occupancy rates, NHS Scotland, March/April Census 2014 – 2023.
|
NHS Board of treatment |
2014* |
2016* |
2017* |
2018 |
2019* |
2022 |
2023 |
|
NHS Ayrshire & Arran |
66% |
69% |
70% |
76% |
82% |
86% |
90% |
|
NHS Borders |
91% |
79% |
79% |
84% |
70% |
67% |
93% |
|
NHS Dumfries & Galloway |
72% |
58% |
65% |
65% |
76% |
84% |
94% |
|
NHS Fife |
74% |
73% |
88% |
83% |
82% |
83% |
89% |
|
NHS Forth Valley |
90% |
83% |
85% |
85% |
78% |
86% |
84% |
|
NHS Grampian |
89% |
87% |
84% |
83% |
87% |
85% |
95% |
|
NHS Greater Glasgow & Clyde |
94% |
96% |
89% |
88% |
93% |
88% |
89% |
|
NHS Highland |
87% |
92% |
92% |
82% |
80% |
97% |
78% |
|
NHS Lanarkshire |
77% |
71% |
73% |
68% |
69% |
67% |
78% |
|
NHS Lothian |
94% |
92% |
94% |
94% |
90% |
86% |
93% |
|
NHS Tayside |
82% |
80% |
82% |
86% |
77% |
92% |
92% |
|
NHS Western Isles |
95% |
88% |
82% |
92% |
60% |
80% |
c |
|
State Hospital |
92% |
89% |
84% |
90% |
91% |
94% |
91% |
|
NHS Scotland |
86% |
85% |
85% |
84% |
84% |
86% |
89% |
* These years are missing some hospital wards and figures are approximate.
c - suppressed due to small numbers.
Historically, hospitals in highly populated areas tend to have higher bed occupancy rates compared to rural areas. Hospitals in close proximity can easily transfer patients between facilities to maximize efficiency. On the other hand, rural hospitals need to maintain spare capacity to accommodate an increase in patients requiring admission.
However in 2023 this has not generally been the case, with higher than average occupancy rates in some more rural health boards – for instance NHS Borders and NHS Dumfries & Galloway.
Boarding and on-pass patients
If a patient is "boarding" from another hospital, it means they are staying in a hospital outwith their local catchment area. This may happen because there were no available beds in a closer hospital. It may also be because their local hospital lacks the necessary services to provide appropriate treatment.
In the 2023 Census, there were 105 patients who were boarding from another hospital. Out of these, 73 patients (70%) were boarding to another hospital within the same NHS Board. It's important to note that even when a patient is treated in the same NHS Health Board, this can still mean significant distances between their home and the treatment hospital. Additionally, some of the 105 patients may include individuals funded by the NHS in another UK nation but receiving treatment in NHS Scotland.
Table 5: Number of patients “boarding” from another hospital in NHS Scotland, 2016 – 2023
Psychiatric, addiction or learning disability inpatients, NHS Scotland, March/April Census 2016 – 2023.
|
Measure |
2016* |
2017* |
2018 |
2019* |
2022 |
2023 |
|
Number of patients “boarding” |
55 |
38 |
39 |
37 |
70 |
105 |
|
Number of patients “boarding” same NHS HB |
45 |
30 |
29 |
28 |
47 |
73 |
* These years are missing some hospital wards and figures are approximate.
Patients who are "On Pass" are still considered inpatients of a hospital. However they are allowed planned leave for different periods as part of their recovery care plan. This also applies to those whose detention under the Mental Health Act has been suspended. When a patient is "On Pass," their bed may be utilized by another patient.
During the 2023 Census, there were 63 patients (2%) “On Pass” for at least an overnight period. Among these patients, 46 (73%) were “On Pass” to their own homes.
Hospital-Based Complex Clinical Care (HBCCC)
Some patients care needs cannot be met in any other setting apart from a hospital and they require long-term complex clinical care. These patients are considered to be receiving HBCCC. Under the definition of HBCCC, a patient cannot be classified as a delayed discharge. Starting in 2016, the Inpatient Census includes data on patients receiving Hospital Based Complex Clinical Care (HBCCC).
17% of patients (509 patients) in mental health or learning disability beds received HBCCC, a 3% increase from 2022. 33% of these patients were treated in NHS Greater Glasgow & Clyde.
There is a separate and more detailed report on HBCCC from the Scottish Government. This covers HBCCC patients in mental health or learning disability inpatient beds, patients treated outwith NHS Scotland, and patients in General Acute hospitals.
Delayed Discharge
Timely discharge from the hospital is crucial for quality care. It reflects person-centred, effective, integrated, and harm-free treatment. Delayed discharge happens when a hospital patient, who is ready for discharge, continues to occupy a bed.
In the 2023 Census, there were 321 delayed discharge cases, accounting for 11% out of all patients for whom this data was available. This is a one-percentage point increase from the 2022 census. The data was not available for 102 patients, and not returned for 44 patients.
Among known patients, NHS Dumfries & Galloway had the highest proportion of delayed discharges, affecting 1 in 4 patients (25%). In contrast, NHS Western Isles and State Hospital had the lowest proportion, with no patients experiencing delays.
The average (median) length of delayed discharge at the 2023 Census was just under three months (87 days), which is 19 days more than in 2022. 18 patients experienced delayed discharge without a specific delayed discharge date in 2023.
Table 6: Average (median) length of delayed discharge in NHS Scotland, 2014 – 2023
Psychiatric, addiction or learning disability inpatients, NHS Scotland, March/April Census 2014 – 2023.
|
Measure |
2014* |
2016* |
2017* |
2018 |
2019* |
2022 |
2023 |
|
Average (Median) Days |
65 |
71 |
65 |
72 |
88 |
68 |
87 |
|
Average (Median) Banded |
2.1 |
2.3 |
2.1 |
2.4 |
2.9 |
2.2 |
2.9 |
* These years are missing some hospital wards and figures are approximate.
Length of Stay
The average (median) length of stay in a facility is significant as it affects service provision by reducing patient and bed turnover. At the 2023 Census, the average (median) length of stay was 140 days (4.6 months), slightly higher than the 2022 Census. Over the years, the average (median) length of stay has shown some variation, decreasing from 160 days (5.3 months) in 2014.
Table 7: Average (median) length of stay in NHS Scotland, 2014 – 2023
Psychiatric, addiction or learning disability inpatients, NHS Scotland, March/April Census 2014 – 2023.
|
Measure |
2014* |
2016* |
2017* |
2018 |
2019* |
2022 |
2023 |
|
Average (Median) Days |
160 |
147 |
156 |
136 |
142 |
132.5 |
140 |
|
Average (Median) Banded |
5.3 |
4.8 |
5.1 |
4.5 |
4.7 |
4.4 |
4.6 |
* These years are missing some hospital wards and figures are approximate.
Contact
mhic@gov.scot
There is a problem
Thanks for your feedback