Target 2030 for Scotland

Good practice guidance: discharge for adults with incapacity

The Scottish Government has published good practice guidance to support adults with incapacity (AWI) with regards to discharge from hospital, following 12 months of discussions with health and social care partners from across the country to discuss delayed discharge rates in this area.

The discussions explored the challenges that partners have faced, with common issues including a lack of trained mental health officers and difficulties recruiting this role, delays with the court system causing backlogs, and delays with progression of private guardianships.

The Scottish Government has shared a number of good practice examples, including appointing a specific mental health officer to chair meetings regarding AWI; implementing a tracking system for all AWI delayed discharges and meeting daily to monitor progress of these cases; and developing a prioritisation framework and guidance that all mental health officers work with, along with having six mental health officers who focus specifically on delayed discharges cases. The best practice examples can be found in full here.

Leading on from their discussions with partners, and with the good practice examples in mind, the Scottish Government has developed 10 key recommendations that they suggest for services where AWI delayed discharge is an issue.

The recommendations include considering recruitment of sessional mental health officers to support the workforce; ensuring that the workforce is fully aware of AWI legislation and practice; integrating social workers and at least one mental health officer to hospital discharge teams; prioritising recording systems or AWI tracker progresses to monitor delays and highlight emerging issues; and ensuring that health and social care partnerships have daily contact with support providers to ensure an accurate picture of social care capacity. In addition, the recommendations suggest that key team members should develop working relationships with the local Sheriff court staff to support better communication about court delays; timescales should be set for intervening to ensure that families are engaged in the private guardianship process; partnerships should consider the application for an interim guardianship order where a placement is identified, where possible; and partnerships should also ensure promotion of powers of attorney at appropriate stages in working with adults in health and social care. Finally, the recommendations point out that that Section 13ZA “remains a helpful tool” to be used where appropriate, and provides more information on this here.

Over the next months, the Scottish Government concludes, it will be monitoring the number of delayed discharges linked to AWI and will contact areas seeing increased numbers to offer support.

Click here to access the guidance in full.

What else has been happening in Scotland with regards to health in the past year?

In July, we covered a research project which highlighted the views of women in Scotland on the effects of discrimination in health.

June saw us take a look at Scotland’s Learning for Sustainability Plan and how it relates to health and care.

Earlier in the year we looked at NHS Scotland’s environmental plans and progress, which you can find here.