Recording Delayed Discharges in MHSDS quick guide to submitting data

A mental health delayed discharge period is the period of time during a consultant episode (hospital provider) under a main specialty code (mental health) that the patient is clinically ready for discharge, but discharge is delayed, this does not include transfers of care to other acute inpatient services. The point at which someone is Clinically Ready for Discharge is reached when the multidisciplinary team (MDT) conclude that the person does not require any further assessments, interventions and/or treatments, which can only be provided in an inpatient setting.

There are three main criteria which need to be met before the MDT can make this decision:

• there must be a clear plan for the ongoing care and support that the person requires after discharge, which covers their pharmacological, physical health, psychological, social, cultural, housing and finances, and any other individual needs or wishes
• the MDT must have explicitly considered the person and their chosen carer/s’ views and needs about discharge and involved them in co-developing the discharge plan
• the MDT must also have involved any services external to the provider in their decision making where these services will play a key role in the person’s ongoing care e.g. social care teams

NHS England is working to improve the recording and reporting of delayed discharges using the Mental Health Services Data Set (MHSDS).

View the MHSDS published figures.

This table lists all MHSDS fields needed by NHS Englandl to compile these measures, alongside the mandatory tables and data items needed to make a submission to the MHSDS. More information can be found in the MHSDS User Guidance and Technical Output Specification.

Furthermore, the following 5 tables need to be submitted in each submission with their respective mandatory and required fields. More information can be found in the MHSDS User Guidance and Technical Output Specification.

The hospital spells table is considered mandatory in the context of delayed discharges - as the MHS518ClinReadyforDischarge will be rejected without a corresponding MHS501HospProvSpell for the same HOSPITAL PROVIDER SPELL IDENTIFIER.

MENTAL HEALTH CLINICALLY READY FOR DISCHARGE PERIOD DELAY REASON (ClinReadyforDischDelayReason)

The following table outlines all the mental health clinically ready for discharge period delay reason codes for MHSDS version 6.0 within table MHS518ClinReadyforDischarge.

The table lists suggested attributions that can be used against each of the reason codes, however these are not mandatory and should only be submitted where there’s a local need for it to be submitted.

A person must only be counted in ONE category of delay each day. This category should be the one most appropriately describing their reason for delay on a given day however this category can change each day, as can the attribution (where this is recorded). The total numbers allocated across the reasons for delay must equal the total number of delayed days.

Where the reason for the delayed discharge changes during the whole ‘clinically ready for discharge’ period, multiple reasons can be attributed, by flowing multiple records with consecutive Start and End dates.

For example, if the total length of delay is 10 days, the first two days were due to waiting for an NHS-led assessment to be arranged and the following eight days were due to awaiting availability of placement in care home without nursing, then the delayed days will be split across category 35 (two days) and category 07 (eight days).

Note that there are in-depth descriptions for when to use each code below in the 'Further definitions for the delayed discharge reason codes' appendix of the MHSDS User Guidance

MENTAL HEALTH CLINICALLY READY FOR DISCHARGE PERIOD ATTRIBUTABLE TO INDICATION CODE (AttribToIndic)

The table below lists the valid parent codes that provide an indication to which ORGANISATION the Clinically Ready for Discharge Period is attributable.