Last week, there were 21 patients placed beyond Norfolk & Suffolk by Norfolk & Suffolk NHS Foundation Trust (NSFT). That means as far away as Bradford, Weston-Super-Mare, Hastings, Dorking, or London. These are not ‘specialist placements’ but patients who could be treated on an open acute ward, such as Waveney Ward, Glaven Ward , or the now-closed Thurne Ward at Hellesdon Hospital.
Other patients are technically ‘not out of area’ as defined by NSFT but are still many miles away from their home, family, friends, carers, GP and support workers.
The consequences of this lack of beds are:
- Patients who would agree to a local admission as a voluntary patient, but refuse an admission to a hospital many miles away from family, end up being detained – unnecessarily – under the Mental Health Act (Breach of Section 131.1, 1983 Mental Health Act, Breach of Code of Practice Principles 1.2, 1.3,1.4,1.5. See also Department of Health Reference Guide, paragraph 37.2, page 293)
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Patients detained under the Act are given priority for admission over voluntary patients, even when the clinical need is equal – voluntary patients can then end up waiting days or even weeks, for an admission to hospital
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Patients who require urgent admission under the Act cannot be detained because an admitting hospital cannot be identified – this means that – following an assessment – the patient has to be left to his or her own devices
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In other cases, the assessment itself is delayed – sometimes patients are then kept overnight in police custody or in a place of safety, on dubious legal authority, while a bed is found
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Following admission, no proper after-care planning can take place because the patient is being treated often hundreds of miles from the responsible care team
The responsible professionals, the Approved Mental Health Professionals (AMHPs), have been informing NSFT management of the implications of the lack of beds within the Trust since the beginning of 2012 through meetings with the Chief Executive and correspondence informing NSFT of numerous critical incidents. Yet still the disgraceful situation continues and worsens.
There is an on-going bed crisis at NSFT.