Trusts warned not to axe acute beds prematurely

Mental health trusts have been warned not to cut acute beds until their community services are fully developed. In a report about bed over-occupancy, the Mental Health Act Commission found that in the year leading to July 2006 the national average for bed occupancy in acute admission wards visited was 101 per cent. In London it was as high as 112 per cent.

Who's Been Sleeping in my Bed? The incidence and impact of bed over-occupancy in the mental health acute sector highlights the distress and detrimental effects seen in patients who are asked to take leave or move wards to vacate a bed.

Senior MHAC policy analyst Mat Kinton, author of the report, said: 'There has been much on the development of community services as an alternative to admitting patients to hospital, but we have found that some community services are very much embryonic.

'In some areas authorities have cut beds in the hope that the new community outreach projects will take up the slack and that has not universally happened yet. It will eventually, in two or three years -but there is a danger of clipping it too far as it's easy to make cuts when feeling the financial pinch.'

Although Mr Kinton could not say whether bed over-occupancy had worsened over the years, he highlighted one instance in which a patient was kept waiting for nearly a month.

He said: 'I think there were some surprises in the effects on patient care such as a patient sitting in Manchester for 28 days awaiting a bed. I have worked for the MHAC for about 12 years and that has never happened before - where a patient has had to wait for so long.'

The report focused on 15 wards in which two instances of over-occupancy had been recorded.

Of the 17 patients interviewed, two had been asked to go home on leave authorised by their doctor under section 17 of the act, and 11 had been asked to move ward for bed management purposes while four patients could not be admitted to their local acute facility due to bed pressures.

The responses revealed a lack of notice and choice in the experience, and bed management had been unsettling, with five patients informed on the day of their move and seven reporting no advance warning.

The report also said the possibility of losing a room or bed made patients reluctant to leave and staff believed that bed transfers could compromise relationships with patients.

The commission plans to follow up this report by going into the identified hospitals once or twice a year to put pressure on them to address the problem.

It will also report back to the DoH on hospitals that in its view are not managing the beds safely and appropriately.

Further news on:
http://www.hsj.co.uk/healthservicejournal/pages/n1/p12/061116

Coming only a week after the most damning 400 page report (16 Nov 06) Scandal of Labour's blunders that led to murder by mental patient when the needs of dangerous psychiatric patients are being put before the safety of the general public, this further report on mental health provision is very worrying.

The highly critical report into how a psychiatric patient at a south London hospital escaped and attacked Denis Finnegan as he cycled through Richmond Park revealled how a catalogue of systemic errors led to his death.

Chaired by Robert Robinson, a mental health lawyer, the report is said to be one of the most damning in the past decade. Over 400 pages it details a catalogue of preventable errors at Springfield Hospital which led to Mr Finnegan's murder. It concludes that a special medium secure facility in the hospital, the Shaftesbury Unit, must be closed pending an external audit.