The Scottish Government commissioned Healthcare Improvement Scotland to provide local support to three areas in Scotland (Glasgow City, Dumfries and Galloway, and Forth Valley) to reduce delays in hospital discharge for Adults with Incapacity (AWI). This local support ran from July 2024 until June 2025.
This page contains the outputs created during this local support.
Our learning report
This report summarises our learning about AWI hospital discharge delays to inform future action by others. The area of AWI has had a wide range of prior work to change, improve and respond to challenges. This report does not seek to provide a detailed description of this earlier work. Instead, it covers our learning from our review of previous work, engagement with national and local stakeholders across Scotland, and our improvement work in Glasgow, Dumfries and Galloway and Forth Valley.
Access and download our learning report here.
People's journeys
As part of our local work and engagement with national and local stakeholders, we observed that discussions among decision-makers in relation to AWI delays tended to focus on the technical aspects of the process that could be improved. However, we felt that there was a gap in the available evidence that articulated the entire experience of the individual from hospital admission to discharge.
We undertook interviews with consultants, nurses, social workers and mental health officers across different settings and geographies within Glasgow to explore the details of 25 cases of people who had a hospital stay in the past 5 years where AWI processes were at play. We drew on these 25 cases to develop 9 composite stories.
Access and download our 9 stories here. Please note it is in PowerPoint so that you can copy and paste the journeys into your own reports and presentations.
System impacts
As part of our local work and engagement with national and local stakeholders, we observed that decision-makers tended to deprioritise AWI delays. While AWI numbers can be low, the average delay is significantly longer than standard delays, meaning that a few individuals delayed represent a high number of bed days. The impacts of AWI delays are not just felt by the social workers, mental health officers and medical staff looking after the individual. They have knock-on impacts felt around the wider system.
To support prioritisation discussions among decision-makers, we developed a system impact infographic for Glasgow that outlined the nature and extent of the impact of AWIs in the broader system.
Access and download our System Impact infographic here.
Info pack
This resource contains core information on the various components of the Adults with Incapacity (AWI) processes and relevant legislation. It attempts to bring core information together in one place as simply as possible, making it easier for professionals to access a nationally consistent set of information they can use when discussing Adults with Incapacity processes and legislation with each other. It does not seek to replace local legal advice, nor does it aim to supersede the education programme currently under development by NHS Education for Scotland and the Mental Welfare Commission.
This area of law and practice is nuanced. At its heart, it is about supporting and protecting the rights of vulnerable adults. To do this well requires case-by-case judgement calls that draw on expertise and knowledge from a wide range of professional groups to get the best outcome. Therefore, the best learning in this area comes from open and trusted discussions within and between professional groups. This resource will have the most impact when it facilitates discussions between professionals to arrive at a shared understanding.
This pack is not intended for direct use with the person, their family, or relevant others. It is a professional-to-professional resource.
Publication of this resource is pending and awaiting sign-off.