Report finds some people have been in hospital more than 25 years

Some people with learning disabilities and complex care needs have been in hospital for more than 25 years, according to a new report.

The Mental Welfare Commission’s ‘Hospital is not home’ report looked at the circumstances of 55 people who were identified as having been in a learning disability or mental health hospital for more than 10 years.

It found that such people are staying in hospital for too long – 18 years and two months on average – while 10 people had been in such settings for more than 25 years.

The Equality and Human Rights Commission said it is “deeply concerned” at the findings and urged the Scottish Government and all health and social care agencies to ensure they are complying with legal requirements on equality.

The Mental Welfare Commission said it is well documented that people who remain in long-term hospital placements suffer adverse effects, including the loss of independent living skills which often leave them unable to cope with day-to-day living outside an institutionalised setting.

Proper compliance with the equality legal framework is critical in all health and social care settings

It looked at people who were on the Dynamic Support Register which was launched in May 2023 to help ensure that people remain in hospital only for as long as they need assessment and treatment.

Julie Paterson, chief executive of the Mental Welfare Commission, said: “The Scottish Government asked the Commission to review the care and treatment of people with learning disabilities and complex care needs who had remained in either a learning disability or mental health hospital for more than 10 years.

“We found that the implementation of the Dynamic Support Register has yet to ensure the right to live independently and the right to be included in the community for a small but significant group of people on that register.

“We also found that there may be people who are in hospital for long periods of time and who are not on any lists or register and are not subject to any legal safeguards. We want to ensure that they are not hidden nor forgotten.”

The Commission found some evidence of commitment to inclusive and active discharge planning from hospital. However, it found that there was also reluctance and concern regarding the availability and capacity of community care resources to safeguard the person and meet their needs.

It also found that there is inconsistent interpretation across Scotland as to who should or should not be on the Register, which was recommended in the Scottish Government’s 2022 Coming Home Implementation report.

Dr Lesley Sawyers, Scotland Commissioner at the Equality and Human Rights Commission (EHRC), said: “The Equality and Human Rights Commission is deeply concerned by the findings of this new report by the Mental Welfare Commission for Scotland, which gives much-needed insight into the experiences of people held in hospital for over 10 years.

“Proper compliance with the equality legal framework is critical in all health and social care settings to ensure people have the support they need to make decisions about their care and independent living.”

She added: “It is evident from these findings that the Scottish Government’s ‘Coming Home’ Strategy has not yet succeeded in its aim to ensure that people are only in hospital for as long as they require treatment.

“We urge the Scottish Government and all health and social care agencies to pay close attention to these findings and take urgent action to ensure proper compliance with equality legal requirements.”

Mental wellbeing minister Maree Todd said: “I welcome this commissioned by the Scottish Government report, and will consider its findings and recommendations in full.

“It is completely unacceptable that people are spending time in hospitals or other care settings when they are medically fit for discharge.

“For every day spent unnecessarily in hospital, a person loses part of their connection with their community, their family, and their friends.

“Discharge planning should begin at the point of admission and provide high-quality care and support for people with learning disabilities to live in their home communities.

“This is why we have provided additional support and investment to health and social care partnerships to deliver improvements.

“Nonetheless, we are clear that more needs to be done to support people in hospital, their families, and staff.

“This must balance a national focus with strong local leadership.

“Change in this area cannot be delivered by the Scottish Government alone, and we will continue to work closely with Cosla and other partners to deliver the change required.”