Bed Blocking
I hate the term ‘bed blocking’ but it’s something that came up a lot when I was working in the Adult Community team. It seems to imply some kind of intent or purposeful wish to disrupt the smooth-running (or not) of hospitals.
The term is used in relation to hospital beds and the need to ‘release’ those beds when the occupant is ‘medically fit’.
Perhaps because we are based at the psychiatric hospital and we (the community mental health team, that is) pop onto the wards with frequency, we are not put under the same amounts of pressure to discharge as happens on in the general hospital but it’s also an issue of ‘demand for beds’.
As well as that, there is the issue of payment. The Community Care (Delayed Discharges) Act 2003 allowed for local authorities to be charged by hospitals for patients whose discharges were delayed by ‘social care needs’.
Currently, mental health wards are exempt from these charges although there have been rumours and mutterings that this might change at some point.
Why do I mention this now? Because since Christmas, I have been asked to arrange two assessments for two patients in the general hospital who are medically fit to be discharged. In both situations there are reasons that the discharge cannot be a straightforward discharge home. In neither cases did I feel that the risks and the degree of the mental disorder necessitated a compulsory admission into the psychiatric hospital.
Sectioning someone is not an answer to a blocked bed. In both situations, there is no way we would have considered admission to hospital had these people been exhibiting the same symptoms in the community. Actually, in one of the cases, the patient had been experiencing the same symptoms for a number of years prior to admission to hospital.
It’s not that I can’t understand the pressures that are faced on the wards, especially at this time of year, but I found it vaguely worrying that a psychiatric admission (especially a forced one) seems to have been considered as a first choice rather than a last choice option.
Posted on January 15, 2009, in AMHP, ASW, elderly, mental health, old age, social work, work and tagged bed blocking, community care (delayed discharge) act 2003, delayed discharge, health, hospital, Medicine, mental health act, psychiatric hospital, social work. Bookmark the permalink. 9 Comments.
What a terrible state of affairs. The fact that so many of our hospitals are being run at 100% bed occupancy has to indicate that we have gone too far in reducing the number of beds available. It seems to be medicine -by-numbers as far as managers are concerned, and woe betide the patient who needs a little longer in hospital than the figure in their protocols, or if they have needs when they leave hospital that cannot be met at the time of their projected discharge. The thought that someone should be suggesting that a patient be sectioned just so that a bed in a general hospital becomes free is obscene to say the least.
That is really really scary and I agree with madsadgirl, it is terrible state of affairs.
Lola x
I agree with the comments on this one, but I can’t say I’m surprised it happens.
Thanks all for the comments. Yes, it is reprehensible. Beyond that really. I suspect it was partially ageist too.
This problem also happens in referral from acute to rehab wards. The rules say that you have to wait for a bed in rehab in acute – not from supported accomodation.
So, a lady I was in hospital with last February and who was referred to rehab in March is STILL sitting on her by now very bored arse in the acute ward. A second lady joined the same queue a few months later, and a third had only just moved having also waited a year.
Needless to say, the acute ward does not sit mostly unoccupied, short of occupants for the beds…
ps I went to look at your cat pics on flickr (I can never resist a cat gallery) and they are soooo cute. I love the converted monitors!
I have 2 ‘bed blockers’ ofmy own, and they are very good at it
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DeeDee – It does seem like a ridiculous situation doesn’t it? Especially as the need for acute beds (and the cost of them) is so high. And unfortunately, I can take no credit for the cat or the photo.. he isn’t my cat… I just grabbed the photo from flickr (and credited it, of course!) . . I would love to have cats but I am in a first floor flat in London.. so I content myself with looking at pictures of other peoples’…
Ah I see…. well his owner is lucky to have a cat like that. The photo does show a very effective feline bed blocking manoeuvre, grabbing as much of the usable sleeping space as possible
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