The number of patients stuck in NHS mental health units in England despite being clinically ready to leave has reached its highest level in at least eight years.
“Delayed discharges” of patients from hospitals in NHS mental health trusts reached 49,677 days in March, according to an analysis – a higher figure than in any month since at least January 2016, when NHS Digital started publishing the data.
Delayed discharges stood at 39,098 in April 2023, having risen from a pandemic low of under 17,000 in July 2020. Before the pandemic they ranged between 20,000 and 30,000 days a month. “Delayed discharges” are recorded when a patient is ready to leave hospital but is unable to for non-clinical reasons, leaving them in effect stranded. This can reduce the availability of beds for incoming patients.
The figures show the number of days in which patients who were clinically ready to leave hospital were not discharged. If five patients each had their discharge delayed by 10 days, this would count as 50 days in the monthly figures.
More than one in five delayed discharges in March were caused by patients having to wait for a care home place to become available, with a similar proportion caused by delays in finding supported housing. Other common factors include delays in providing non-hospital-based NHS care or social care in patients’ own homes.
The highest number of delayed discharges were recorded at Barnet, Enfield and Haringey Mental Health NHS trust, in London, and East London NHS foundation trust.
Dr Lade Smith, president of the Royal College of Psychiatrists, said: “Delays to discharge are very often caused by a lack of social care and local authority provision in the community. Many patients with severe mental illness have unmet housing needs or financial worries that pre-date their admission to hospital, meaning additional support is needed before they can return home.
“Mental health social care providers help reduce people’s length of stay in hospital. They provide vital advice, community support and crisis services which also prevent people from needing to be admitted in the first place. The withdrawal of funding from social care and local authorities following the pandemic resulted in a sharp increase in the number of delayed discharges.
“An additional £100m investment will be necessary to adequately address this issue.”
Mark Winstanley, chief executive of the charity Rethink Mental Illness, said: “It’s deeply concerning that these figures show an increase in delayed discharge. Keeping people in hospital longer than necessary prevents them from rebuilding their lives and continuing their recovery.
“The data reveals how a lack of resource in other parts of the system have a domino effect, with access to NHS community care, social care and supported housing among the key factors causing delays.
“People severely affected by mental illness often need continued support when they leave hospital, and this data suggests this support is patchy and in short supply. At a time when there is high demand for inpatient care for people in crisis and a shortage of available beds, this issue is placing huge pressure on inpatient services. The next government must fix our mental health system and ensure that the wider support people need is resourced to meet demand.”
Coroners have written to the Department of Health and Social Care warning of the impact of mental health bed shortages. In March, a coroner warned that 20 patients in Suffolk were stuck on a waiting list for an informal inpatient mental health bed, with none available elsewhere in the country, at the end of an inquest into a suicide that was directly attributed to a lack of mental health beds.
An NHS England spokesperson said: “While services are being expanded and transformed thanks to £2.3bn NHS Long Term Plan funding, there is no doubt mental health services are under significant pressure.
“We work closely with colleagues in social care and local government to tackle factors affecting delays, such as housing and care home placements.”
