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DoLS statistics
The most recent DoLS statistics for the period 1 April 2017 to 31 March 2018 have now been published.
There were 227,400 applications for DoLS received during 2017-18, with almost three quarters relating to people aged 75 and over. This represents an increase of 4.7% on 2016-17 although the rate of increase is slowing compared to previous years.
| Applications received | Year-on-year change | |
|---|---|---|
| 2013-14 | 13,715 | - |
| 2014-15 | 137,540 | 123,825 |
| 2015-16 | 195,840 | 58,300 |
| 2016-17 | 217,235 | 21,395 |
| 2017-18 | 227,400 | 10,165 |
| Source: NHS Digital | ||
There were more DoLS applications received than were completed (181,785) in 2017-18. The number of DoLS applications that were completed increased by 19.6% from 151,970 in 2016-17. The proportion of these that were granted was 61.1% in 2017-18.
The reported number of cases that were not completed as at year end was 125,630. Of these just under 40% (48,555) were received prior to 1 April 2017 – in other words, had still not been completed at least a year after they had been received.
The average length of time to complete a DoLS application increased from 120 days in 2016-17 to 138 days in 2017-18, although in addition the number of applications completed within 90 days increased by a fifth. Nationally the proportion of standard applications that were completed within 21 days (as required in the regulations and the Code of Practice) fell from 23.3% in 2016-17 to 21.7% in 2017-18. The range of months it would take for local authorities to clear their applications not completed as at 31 March 2018 if they did not receive any new applications, based on their rates of completion during 2017-18 ranges from 0 months to 61.6 months, the average being 7.6 months.
As in previous years, there was a wide range of variation across the country in the volumes of DoLS applications, their outcomes and how they were administered. As in previous years also, however, the bare statistics are difficult to compare because of the very different practices that different local authorities have adopted in order to try and keep abreast.
The statistics can be fleshed out by reference to the picture of DoLS provided in the CQC’s annual State of Care report for 2017/2018. Although good practice was highlighted in a number of places, as in previous years, the CQC:
continued to observe variation in how care home and hospital providers use DoLS and the MCA. This variation can lead to poor practice and have a negative effect on people using services, for example unnecessary restrictive practices that can result in a loss of freedom. In some cases, these practices can breach people’s human rights. Our inspections found that although most care home providers comply with DoLS legislation, there remains variation in the quality of how the safeguards are applied in services.
Depressingly:
Varied practice appears in diferent ways depending on the sector, but is commonly linked with a basic lack of understanding of DoLS and the wider MCA. This can then be reinforced by limited staffing levels and a lack of time to complete applications, as well as inadequate staff training. The general complexity of the DoLS legislation and a lack of local authority resources to deal with the number of DoLS applications also influence varied practice.