A massive disc herniation can pursue a favourable clinical course. If early progress is shown, the long-term prognosis is very good and even massive disc herniations can be treated conservatively.

INTRODUCTION The aim of this paper was to analyse patients who were unable to be discharged from a surgical ward despite being surgically fit to leave.PATIENTS AND METHODS Data were collected on all surgical in-patients on a single day. Patients who were surgically fit for discharge but whose discharge was delayed were identified. Demographic data and reasons for delay were noted.RESULTS Nine of 75 patients (12%) were surgical bed blockers. These patients were more likely to have been admitted as emergencies ( P = 0.035) and were older ( P < 0.01) than the remaining patients. They occupied 35% of the total 'bed-days' of the group as a whole with a median in-patient stay of 41 days compared with 2 days for the other patients. Trust-collected data, based on UK Government guidelines, showed only one surgical delayed discharge patient on the day studied.CONCLUSIONS Due to problems in defining delayed discharge Government figures probably underestimate the true numbers. Lack of intermediate care and social service provision are a major cause of bed blocking.