mwcScotlandAlmost a third (32%) of patients in learning disability units in Scotland's hospitals have been identified as ready for discharge, but do not make the move back into the community for months or years, a report has found.

The Mental Welfare Commission for Scotland’s report found that 58 people with learning disabilities are awaiting discharge in Scotland, from a total of 180 inpatients. 

It also reported that the situation varies across health board areas. Those with the largest number of beds have the greatest numbers of people waiting to leave hospital. In NHS Lothian, 46% of patients – 17 people – are in hospital when they no longer need hospital care.

The Commission visited all hospital units for people with learning disability in Scotland excluding forensic services, examining the records of 104 people – more than half of all inpatients – meeting with 46 patients individually and hearing from 47 of their carers and relatives.

Some patients had been waiting in hospital for years, with one waiting to be discharged for almost 9 years at the time of the Commission's visit.

In addition to discharge delays, the report looked at patients' quality of life, and found many good points, but also found that the biggest problem was lack of space for facilities in hospital units, such as therapeutic kitchens so that patients can be supported with skills to help them live in the community. Some units were also poorly maintained.

Colin McKay, chief executive of the Mental Welfare Commission, said: "The main reasons for delays in discharge were lack of funding, lack of accommodation, lack of an appropriate care provider, or a combination of these issues.

"We understand that some people need complex care and support, which can take time to put in place. But a hospital is not designed to be a home, and having people stay for years in a hospital environment, often without all the facilities they should have, is not acceptable.

"We're calling for the Scottish Government, as a matter of urgency, to work with the new integrated joint boards to end these long delays in discharge, and to ensure all learning disability inpatient units are fit for purpose."

The Commission also reported that the majority of care and treatment plans for people with learning disabilities in hospital were good and that patients had a good programme and reasonable range of activities in and out of the hospital.

Families and carers were also generally complimentary about the services, including being made to feel welcome, visiting arrangements, communication with staff, and involvement in reviews.