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Welsh Government
Data Provider: Welsh Government Experimental Statistics Pathway of Care Delays by reason for delay and date

The data represent the number of adults occupying an NHS hospital bed, who were 'clinically optimised' ready to return home or move on to the next stage of care, that experienced a delay in their transfer of more than 48 hours beyond the point they were clinically optimised. 'Next stage of care' refers to all destinations outside of NHS hospitals. The figures are a census snapshot of current delays being experienced at the third Wednesday of each month across Wales. They do not reflect the total number of delays that occurred over the month.

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[Collapse]Local authority of residence[Filtered]
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Local authority of residence 1[Filter]
[Collapse]Local health board provider[Filtered]
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Local health board provider 1[Filter]
Measure1
Date[Filter]
[Collapse]Reason for delay[Filter]
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[Collapse]Reason for delay 1
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Reason for delay 2
Click here to sortApril 2023Click here to sortMay 2023Click here to sortJune 2023Click here to sortJuly 2023Click here to sortAugust 2023Click here to sortSeptember 2023Click here to sortOctober 2023Click here to sortNovember 2023Click here to sortDecember 2023Click here to sortJanuary 2024Click here to sortFebruary 2024Click here to sortMarch 2024Click here to sortApril 2024Click here to sortMay 2024Click here to sortJune 2024Click here to sortJuly 2024
[Collapse]Total1,7501,5261,6251,5701,5521,5981,5511,5671,3611,5481,6391,6611,7121,6261,6521,541
Total[Collapse]Assessment Issues855713716638616622552618486658741755754691676618
Assessment IssuesAwaiting Social worker allocation216175162111114102678861951391321307810499
Awaiting completion of assessment by social care248202203224193206187232164234257292231237228209
Awaiting completion of assessment NursingBefore April 2024, this category also included AHP, Medical, and Pharmacy. From April 2024, these are now reported separately.21218522017416118214014412916116916613610396104
Awaiting Continuing Healthcare (CHC) Assessment36433328462728243524283023423225
Awaiting joint assessment143107989910210513013097143148134168164153127
Assessment through the language of choice.The data item is not applicable1.The data item is not applicable2.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable1.The data item is not applicable12.The data item is not applicable.The data item is not applicable.The data item is not applicable
Awaiting completion of assessment AHP.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable52594737
Awaiting completion of assessment Medical.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable2254
Awaiting completion of assessment Pharmacy.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable222
Awaiting completion of assessment Psychiatry.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable104911
[Collapse]Transfer related issues45463335744042535051744741375557
Transfer related issuesAwaiting transfer to intermediate care bedded facility37371930612932444143653634334852
Awaiting community based health provision D/N CPN56312232343132.The data item is not applicable1
Awaiting integrated health /social care community provision33104685554674243
Awaiting hospital arranged transport.The data item is not applicable.The data item is not applicable1.The data item is not applicable51221.The data item is not applicable.The data item is not applicable3.The data item is not applicable.The data item is not applicable31
[Collapse]Funding issues36405040363937254136435235324632
Funding issuesAwaiting funding decision81920171291213111713161012139
Awaiting funding decision FNC/CHC1915251722251792312252822162820
Awaiting joint funding decision9656258377583453
[Collapse]Home adaptation/equipment issues41292742436452302842384546363139
Home adaptation/equipment issuesAwaiting health completion of assessment/provision for equipment23181425243630181828233225261826
Awaiting social care completion of assessment/provision for equipment7556798656855353
Awaiting completion of adaptations (DFG's)8364413112254410156
Awaiting provision of telecare and /or telehealth equipment112233.The data item is not applicable23122562.The data item is not applicable
Awaiting provision of medicines management dispensing equipment/support22.The data item is not applicable55332.The data item is not applicable2121.The data item is not applicable14
[Collapse]Home care related issues192176185192202185211190175168147187188190202162
Home care related issuesAwaiting start of new home care package179163175178178165202179160154132168174181192157
Awaiting restart of previous home care package101076191255138998783
Awaiting Domiciliary care package self-funding333442232124112.The data item is not applicable
Awaiting CHC new package of care.The data item is not applicable.The data item is not applicable.The data item is not applicable41623.The data item is not applicable54651.The data item is not applicable2
[Collapse]Step down to recover and assess876163706264676865627060107698384
Step down to recover and assessAwaiting reablement care package74475759515855575257504482576973
Awaiting Community Resource capacity13146111161211135201625121411
[Collapse]Disagreements /Legislation99981351179211311914011897104108123139145132
Disagreements /LegislationPatient / family choice related issues28293635251826362212152114243021
Patient/ family dispute CHC outcome1.The data item is not applicable.The data item is not applicable3112533134132
Patient / family refusing to participate in financial assessment.The data item is not applicable1.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable11.The data item is not applicable123.The data item is not applicable11.The data item is not applicable
Patient / family refusing to move to next stage of care/ discharge19242921213332301511262639333635
Disputes between agencies4685453411441012494
Intervention by patient's legal representation.The data item is not applicable141412444421647
Mental Capacity.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable424146343328433538
Safeguarding issues impacting discharge arrangements1561064336104819753
Court of Protection delays.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable12121210916202222
Mental Capacity / Court of Protection delays32314846335250.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable
[Collapse]Care Home placement arrangements342306348369358413416393352376346343351371350337
Care Home placement arrangementsAwaiting completion of arrangements prior to placement79757174596465716065574854686941
Awaiting Residential care home manager to visit and assess (Standard 3 residential)24161926375029382837412228251932
Awaiting Nursing care home manager to visit and assess (Standard 3 residential)41323940354641352437342731282224
Awaiting nursing/residential home self-funding8415132017169819221919161720
Awaiting RH availability63537673557775504647467363705661
Awaiting NH availability59544548585259675355423338474553
Awaiting EMI residential availability29273338334245405042384243374932
Awaiting EMI nursing availability28263341414148495346323639434048
Awaiting specialist bed availability812108121421191617182319212111
Awaiting return to existing care home placement1.The data item is not applicable1.The data item is not applicable12536.The data item is not applicable232214
Awaiting extra care/supported living availability2768781212811141715141111
[Collapse]NHS Bed related issues16161618111013111721231720131918
NHS Bed related issuesAwaiting Mental Health bed10899636681110108799
Awaiting palliative care specialist bed311112.The data item is not applicable2212.The data item is not applicable11.The data item is not applicable.The data item is not applicable
Awaiting palliative care POC.The data item is not applicable112123.The data item is not applicable12312.The data item is not applicable32
Awaiting palliative care home222212.The data item is not applicable221116133
Awaiting Learning Disability bed1333214144453444
Awaiting acute bed.The data item is not applicable1.The data item is not applicable1.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable23.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable.The data item is not applicable
[Collapse]Housing Related Issues37415249584842392937534747484562
Housing Related IssuesHomeless1211181824171922161615915201416
No suitable abode25303431343123171321383832283146

Metadata

Title

Pathway of Care Delays

Last update

22/08/2024 22/08/2024

Next update

19/09/2024

Publishing organisation

Welsh Government

Source 1

Pathways of Care Delays, NHS Delivery Unit

Contact email

stats.healthinfo@gov.wales

Designation

Experimental statistics

Lowest level of geographical disaggregation

Local authorities

Geographical coverage

Local health boards

Languages covered

English and Welsh

Data licensing

You may use and re-use this data free of charge in any format or medium, under the terms of the Open Government License - see http://www.nationalarchives.gov.uk/doc/open-government-licence

General description

A delayed discharge occurs when a patient who is clinically ready for discharge cannot leave hospital because the necessary ongoing care and support or suitable accommodation for them is not yet accessible.
The data represent the number of adults occupying an NHS hospital bed, who were 'clinically optimised' ready to return home or move on to the next stage of care, that experienced a delay in their transfer of more than 48 hours beyond the point they were clinically optimised. 'Next stage of care' refers to all destinations outside of NHS hospitals.
The figures are a census snapshot of current delays being experienced on a specific day in each month across Wales. They do not reflect the total number of delays that occurred over the month.
The data are used to monitor the number of delays, and the reasons for delays, assisting NHS and Local Authority partners to develop regional plans with a focus on outcome based actions to reduce discharge delays across the health system.

Data collection and calculation

Data are provided by Local Health Boards and validated jointly with Local Authority partners.
The Pathway of Care Delays is a snapshot census that identifies people with a discharge delay and reason at a given point each month. Health Boards are required to extract the data from local systems on a census day in each month, and validate the delays with Local Authority partners. Subsequently, data records are entered via a web-based tool and submitted to NHS Wales.


Frequency of publication

Monthly

Data reference periods

April 2023 onwards

Revisions information

Data are subject to revision

Statistical quality

Data are provided by Local Health Boards and validated jointly with Local Authority partners.
The Pathway of Care Delays is a snapshot census that identifies people with a discharge delay and reason at a given point each month. Health Boards are required to extract the data from local systems on a census day in each month, and validate the delays with Local Authority partners. Subsequently, data records are entered via a web-based tool and submitted to NHS Wales.
At the start of the COVID-19 pandemic, the Welsh Government suspended delayed transfers of care (DTOC) reporting requirements, along with many other datasets. The Welsh Government introduced the COVID-19 Discharge Requirements, which included an updated discharge process with increased focus on rehabilitation and reablement to improve patient flow and support better outcomes. From July 2020, delayed discharge data were collected as management information on a weekly basis. These data were not formally validated.
Subsequently a formal replacement, Pathways of Care Delays (POCD) has been developed and tested to replace DTOC. This system has now been rolled out across all Local Health Boards & Local Authorities and the first fully validated and quality assured data are available from april 2023.
Welsh Government discharge guidance (COVID-19 Discharge Requirements) sets out the default approach to hospital discharges – the Discharge to Recover then Assess (D2RA) pathways (or 'recovery pathways').
The D2RA approach is based on evidence of better outcomes for people who transfer as soon as possible to their usual residence or other suitable care setting for rehabilitation or reablement prior to assessments for longer term care. A D2RA pathway (or recovery pathway) could be in a person’s own home, in a community hospital or in an alternative step-down setting.


Keywords

Discharge Discharges