Information Services Division 1 Delayed Discharge Definitions and National Reporting Requirements Advice Note v1.0 Issued April 2019 INTRODUCTION Until recently, the majority of Health Boards have used the delayed discharge data management system, EDISON, to record and report on delayed discharges. As this system is being retired, most areas are now collecting data through TRAK. The ‘shadow’ period in running both systems during the transition, highlighted some issues around data collection. ISD, along with the Scottish Government, held a series of workshops in late 2018 to examine the recording of delayed discharges, and this advice note is the output of these workshops. This document should be read alongside the Delayed Discharge Definitions Manual (DM) and the National Reporting Requirements (NDR) which remain the official guidelines on collecting delayed discharge data. The DM and NDR can be found at http://isdscotland.org/Health-Topics/Health-and-Social- Community-Care/Delayed-Discharges/Guidelines/ .
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Information Services Division
1
Delayed Discharge Definitions and
National Reporting Requirements
Advice Note v1.0
Issued April 2019
INTRODUCTION
Until recently, the majority of Health Boards have used the delayed discharge data
management system, EDISON, to record and report on delayed discharges. As this system
is being retired, most areas are now collecting data through TRAK. The ‘shadow’ period in
running both systems during the transition, highlighted some issues around data collection.
ISD, along with the Scottish Government, held a series of workshops in late 2018 to
examine the recording of delayed discharges, and this advice note is the output of these
workshops.
This document should be read alongside the Delayed Discharge Definitions Manual (DM)
and the National Reporting Requirements (NDR) which remain the official guidelines on
collecting delayed discharge data.
The DM and NDR can be found at http://isdscotland.org/Health-Topics/Health-and-Social-
The National Audit of Intermediate Care describes Intermediate Care as follows: Intermediate care services are provided to patients, usually older people, after leaving hospital or when they
are at risk of being sent to hospital. The services offer a link between places such as hospitals and people’s
homes, and between different areas of the health and social care system – community services, hospitals,
GPs and social care. https://www.nhsbenchmarking.nhs.uk/naic/
3.2. What is Bed Based Intermediate Care?
Intermediate Care beds provide a time-limited episode of intermediate care commissioned
and supported by Integration Authorities and provided within a care home, housing with
care, or in a discrete step-down facility within a hospital site.
Step up-beds - admitted from home for assessment and rehabilitation as an alternative
to acute hospital admission
Step-down beds - transfer from acute hospital for further period of assessment and
rehabilitation.
3.3. What is NOT Bed Based Intermediate Care?
Intermediate Care beds are not:
Transitional care that does not involve active therapy or other interventions to maximize
independence, i.e. patients who are ready for discharge and are simply waiting for
longer-term care packages to be arranged.
Longer term rehabilitation or support services.
Rehabilitation that forms part of acute hospital care. However, these patients should
not be classed as delays, as they are receiving on-going treatment.
Delayed Discharge Definitions and National Reporting Requirements – Advice Note v1.0 April 2019
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3.4. Intermediate Care and Delayed Discharges
Intermediate care is a re-abling, rehabilitative, recovery process with a view to returning the
patient home.
What is the difference between intermediate care bed and a rehab bed?
The simple answer is probably not very much, albeit a hospital rehab ward is unlikely to
have the whole range of MDT support.
Someone receiving rehab will not be a delayed discharge wherever they are as they are still
getting treatment.
Reason code 27A should be used when the person is awaiting availability in an
intermediate care facility.
A person is not a delayed discharge if they are receiving Intermediate Care and
then wait for another service.
It has been suggested all community hospital beds are intermediate care – this is not the
case. Community hospitals will provide a range of diagnostics and treatments, many will
provide surgical procedures.
It is not the intention to reclassify beds, wards or facilities as intermediate care and then
merely move people to wait for another service.
For the purposes of delayed discharge recording, intermediate care beds are
deemed as being in the community. They cannot be in an acute hospital.
Step up-beds -admitted from home for assessment and reablement as an alternative to acute hospital admission.
Transitional care that does not involve active therapy or other interventions to maximize independence, i.e. patients who are ready for discharge and are simply waiting for longer-term care packages to be arranged.
Longer term rehabilitation or support services.
Rehabilitation that forms part of acute hospital care. However, these patients
are not classed as delays, as they are receiving on-going treatment.
Step-down beds - transfer from acute hospital for further period of assessment and reablement.
Information Services Division
Delayed Discharge Definitions and National Reporting Requirements – Advice Note v1.0 April 2019
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4. OPERATIONAL PROCESSES
4.1 Using TRAK to record delays
Operational verification of patients delayed is essential.
Oversight of use by ward staff indicating a person is ready for discharge – this is a multi
disciplinary decision.
Data ‘sense’ check prior to submission of nationally required information is essential
Delayed Discharge Date / Delayed Discharge Reason refers to the date/reason the
delay episode ended, and are distinct from those used on TRAK.
4.2 Out of area delays
The Health & Social Care Partnership of residence MUST be notified of a delayed
patient. This does not happen automatically via TRAK.
4.3 Hospital transfers within the same Health board
If a patient is transferred to another hospital during their delay, the original admission
date should be submitted.
Note that inter-hospital transfers should not be classified as delayed discharges.
4.4 Hospital transfers between Health boards
If a delayed discharge patient is transferred to a hospital in another health board, the
original delay episode should have a discharge reason and date added.
The receiving health board should record a new delay episode, with the date of
admission to their care, and a revised ready for discharge date, according to their
assessment of the patient.
This will avoid the receiving health board being held accountable for delayed bed days
occurring elsewhere.
4.5 Verification of information
All data submitted to ISD on a monthly basis should be verified prior to submission.
Details of the data quality checks undertaken by ISD are available: https://www.isdscotland.org/Health-Topics/Health-and-Social-Community-Care/Delayed-