What can doctors do when they don’t have beds to put patients in?
This dilemma is exactly what seems to be faced by professionals at the Maudsley Hospital, as we report this week.
According to data obtained by this paper, patients experiencing a mental health crisis in public are facing delays in their care.
Those picked up by the police for having a mental health crisis in public can be taken to a ‘place of safety’ at the Maudsley, normally for up to 24 hours.
Data shows many patients are staying in this unit for much longer – in one case, even for up to a month.
The hospital’s staff admit this is both a legal concern and a safety concern.
It is a legal concern, because patients are only supposed to be detained for a normal period of 24 hours. Any detention for longer, the Trust’s board has been warned, could leave it open to legal action.
When asked, the Trust said it would use other legal frameworks in those cases. It did not say what those would be, and did not put up a senior figure at the Trust for an interview.
The hospital regulator has also expressed concern about overstays, saying it would question the legal basis for keeping patients in these circumstances.
It is a safety concern, too. As campaigners point out, a delay beyond 24 hours is a delay for a patient to receive proper inpatient care if they need it.
And according to the Trust’s papers, a lack of beds is a common reason for these delays.
We don’t question the hard-work and effort that doctors and nurses at the Maudsley put in to give their vulnerable patients good quality care.
But it seems that doctors are stuck between a rock and a hard place: A patient could be too unwell to leave the place of safety unit.
But there might also not be an inpatient bed to put them in. The cause of the problem is complex. The solution is relatively simple.
The Maudsley needs more resources: for crisis care, for inpatient beds, and for quick turnaround of cases presenting to the hospital in the grips of a serious mental health crisis.