NSFT seeks to reduce out of area placements by refusing emergency admissions rather than by providing necessary beds

Closed to emergencies

A member of the Norfolk & Suffolk NHS Foundation Trust (NSFT) crisis team writes:

“NSFT seems determined to reduce the number of out of area placements but not by providing an adequate number of local beds. A senior NSFT manager is going around the country trying to discharge out of area patients. How can this be a substitute for proper Discharge and After-care planning under CPA or Section 117 of the Mental Health Act?

This week we in the Crisis Team were caring for two desperately ill patients who needed urgent admission. Two beds became available at Hellesdon Hospital and were identified by the Bed Management Team as needed for our severely ill patients. This decision was overruled by a Deputy Service Manager without any reference to clinical need, and a shuffling exercise of patients took place so that an out of area patient could be transferred back to Norwich.

What happened to our patients? They were left at home in a distressed state with their families struggling to cope. One was subsequently admitted to a hospital over 150 miles from Norfolk and the other at the time of writing is still waiting for admission. In the first case the failure to provide a bed at the right time nearly led to a unnecessary detention under the Mental Health Act.

We have now been told by the Bed Management Team that they cannot even look for an out of area bed until they have made absolutely sure that no bed can be made available in Norfolk and Suffolk. This will mean even further delays in urgent admissions as patients are often not reviewed for discharge until late in the day. For example, yesterday an out of area bed could not be authorised until 3 p.m. although the need for the bed had been identified the day before; it then took two members of CRHT staff until 11.30 p.m. to convey the patient and return to base.

The lack of beds is causing untold distress to patients, unsafe and unethical practice, and sometimes illegal practice. Many staff are off sick with stress and many others cannot wait to leave what was once a great Crisis Resolution Team.”

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