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.