Delayed discharges cost Scotland’s NHS at least £440m, the nation’s public service watchdog has said.
An Audit Scotland report showed more than 720,000 bed days were lost in 2024-25 due to patients being well enough to be discharged.
One in every nine beds in Scottish healthcare settings was occupied by someone who did not need to be there.
Patients can be delayed in hospital for several reasons, but the most common is the lack of a social care package.
While Audit Scotland estimates that £440m was spent on the care of those unnecessarily occupying beds, the true cost is “likely to be much higher”, according to the report released on Thursday.
“Despite only around 3% of all people discharged from hospital experiencing a delay, each delay has a detrimental effect on the individual’s physical and mental wellbeing,” the report said.
“This includes increased risk of infections, reduced mobility and independence and can result in higher social care needs upon discharge.”
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The report states that delays also impact the flow of patients through hospitals, which in 2024/25 resulted in 11.7% of hospital beds being unnecessarily occupied, as well as reduced staffing availability and capacity for other patients.
“This means that the system cannot function as intended, and it will be challenging to meet the projected increase in demand if delayed discharges are not reduced,” the report said.
The situation was said to be a “symptom of much wider challenges across the health and social care system”.
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“The Scottish government, integration authorities and their partners, the NHS boards and councils, have actively targeted delayed discharges as an issue,” the watchdog said.
While this had led to some improvements, it varied across the country as “the lack of a consistent approach to evaluating initiatives makes it very difficult to understand their impact”.
Audit Scotland said better analysis and transparency were needed to understand both the costs and impacts of delayed discharges.
The watchdog also urged the Scottish government and Public Health Scotland to produce an estimate of the total costs and assess current initiatives to stem the problem over the next year.
Health Secretary Neil Gray accepted “more must be done” to ensure people receive the care they need in the right place, at the right time, but also highlighted 97% of all hospital discharges would happen without delay and that there have been improvements in some areas already.
