A patient with "complex" health needs has been waiting more than three-and-a-half years to leave hospital after being declared fit for discharge, it has been revealed.
The patient, who has not been named, and who suffers from a "serious mental health condition" plus a learning disability and physical health problems, has now been in a hospital bed for 1,338 days, according to a letter sent by the Welsh cabinet secretary for health, Vaughan Gething.
The letter, sent to Conservative Assembly member Darren Millar and shown to the Press Association, was in response to the Clwyd West representative's call for details on the longest number of bed days lost by individual patients experiencing delayed transfers of care.
In it, Mr Gething lists the longest delays experienced by individual patients at each of Wales's seven health boards, as of January 2017, and reveals that along with the Hywel Dda University Health Board patient who has been waiting for three-and-a-half years, two other patients in the country have been stuck in hospital beds for more than a year-and-a-half each.
Mr Millar described the delays as "truly scandalous" and said it was clear that a more integrated approach between the Welsh NHS and other care providers was long overdue.
He said: "No patient should have to wait almost four years to be discharged from hospital.
"While bed blocking is extremely costly for the NHS in Wales, the real cost is the quality of life of patients for whom it affects."
The letter goes on to say that it is anticipated that the health board's clinical team anticipates being able to discharge them "in about six months".
Mr Gething wrote: "We have recently been advised that using a bespoke commissioning approach, the health board has secured a provider who is able to meet all of the patient's complex needs, subject to some structural alterations to their premises."
Two other health boards, Abertawe Bro Morgannwg University Health Board (ABMU) (589 days) and Cardiff and Vale University Health Board (583 days) were caring for patients who had been waiting more than a year to be discharged, according to the letter.
Commenting on the letter, a spokesman for the Welsh Government said the figures must be seen in context.
He said: "Delayed transfers of care are at their lowest level for 12 years.
"This is an exceptional achievement, especially when considered against the backdrop of increasing demand on services as our population ages.
"The patients referred to in this correspondence had complex needs associated with mental health conditions and required highly specialist - often bespoke - services to be put in place. None were occupying acute hospital beds."
Mr Gething also wrote that the February census period had shown a reduction in delayed transfers of care for the fourth successive month.
The Labour AM said: "We continue to have lower totals than were previously seen in Wales ... this position has been achieved despite additional pressures the NHS in Wales faces through the winter months and against a backdrop of increasing demand for both health and social care services as our population ages."
Welsh Conservative shadow health secretary Angela Burns AM said the "shocking" figures were "a further indictment of the Welsh Labour Government's failure to process patients through hospitals and into community care within an acceptable timescale".
Joe Teape, director of operations for Hywel Dda University Health Board, said: "We are unable to discuss individual patient cases, however we continue to work hard to reduce delayed transfers of care and have good relationships with our local authority and third-sector partners in providing care in the community as and when appropriate."
A spokesman for ABMU Health Board said the 589-day delay was due to waiting for adaptations to the patient's home to be completed.
He said: "ABMU Health board, working closely with local authority and other partners, strives to discharge patients from hospital as soon as they are well enough to leave, either to their own homes or to the next stage of their care.
"However, our overriding priority is to ensure patients are discharged into a safe environment.
"For some patients this means they will require additional support arrangements to be put in place, which can include home adaptations requiring to be carried out prior to discharge."
Cardiff and Vale University Health Board was contacted for comment.
For each health board the number of bed days lost as a result of an individual patient experiencing delayed transfer of care as of January 2017 were as follows:
- Hywel Dda University Health Board: 1,338
- Abertawe Bro Morgannwg University Health Board: 589
- Cardiff and Vale University Health Board: 583
- Betsi Cadwaladr University Health Board: 330
- Powys Teaching Health Board: 218
- Aneurin Bevan University Health Board: 162
- Cwm Taf University Health Board: 135
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