Public service reform will not ease delayed discharge, social workers warn

Scotland's social work chiefs have challenged government plans to centralise control of social care. Two leading professional organisations claim delayed discharge will not be relieved by proposed public service reform. Structural problems keeping patients in hospital must be addressed as a matter of urgency, Social Work Scotland and the SASW union said. In a joint briefing, the two organisations say delayed discharge is not a governance problem but a capacity issue.

READ MORE: Primary one pupils offered counselling to cope with anxiety The most recent figures from Public Health Scotland show almost 2,000 beds were occupied on an average day by people who were clinically ready to leave hospital. In a rebuke to the Scottish Government's public service reform agenda, the groups argue delayed hospital discharges are being driven by chronic shortages of social care workers, community services, housing and support for people with complex needs.

George Hannah, Policy and Public Affairs Advisor at SASW, said: “If we are serious about reducing delayed discharge, we need to increase the availability of the complex care and support that people need to leave hospital safely. “Our briefing shows that delayed discharge is not primarily a governance problem. It is a capacity problem.” Social workers have said they want investment in services, workforce capacity and provision of supports.

“Without investment in the workforce and the availability of care and support, delayed discharge will persist regardless of how services are organised,” Mr Hannah added. “The priority must be building the care infrastructure Scotland needs." The report references Audit Scotland's 2026 report on delayed discharges, which concluded that the problem was a symptom of wider pressures across health and social care rather than a stand-alone failure of hospital operations.

Workforce shortages, limited community provision, housing constraints and increasingly complex patient needs were identified as key factors. Although more than 96 per cent of hospital inpatients are discharged on time, the briefing argues that delays are concentrated among people whose needs are particularly difficult to meet, including those requiring mental health support, care for learning disabilities, suitable accommodation or legal safeguards.

The organisations warn that an excessive focus on reducing delayed discharge figures could also have serious consequences for patients' rights and wellbeing. Laura Kerr, Head of Policy and Workforce for Social Work Scotland, said the overwhelming majority of people leave hospital when they are ready to do so. “Where delays do occur, they are often linked to some of the most complex circumstances facing individuals and families, which is why continued investment in the social work workforce, community support, housing, and prevention remains so important,” she added.

“Our focus should always be on ensuring people receive the right support, in the right place, at the right time.” Social workers also warn that their profession risks being reduced to a mechanism for moving patients through hospitals more quickly, rather than supporting people to live independently. They are calling instead for investment in the social care workforce, preventative services, housing, rehabilitation and community-based support.

The intervention comes amid wider debate about how Scotland should reform its public services and whether greater central control can improve accountability and outcomes. The Scottish Government has announced plans for major overhauls of public services, including proposals to drastically shrink the number of NHS boards and regional councils. The Scottish Government was contacted for comment.