"Delays in admission to Manchester mental health services"

About: Manchester Mental Health And Social Care Trust

(as a staff member),

I work in Manchester Mental Health and Social Care Trust which provides care to people in Greater Manchester. For the past years, it is very well known that our trust is not performing well. However, this is getting worse lately and has since had a detrimental effect on the patient's care. That's why I decided to share my concern here and hope that someone external can do something about this trust. I am not too sure what can be done to improve the current situation although the front line staffs like myself are doing what we can to help the patients.

Currently, we have a waiting list of 15+patients waiting to be admitted into acute inpatient bed for their mental health needs. All of these patients are acutely unwell, vunerable and present a significant risk to themselves and others. Most of them have been reviewed by two medical officers and both officers had completed medical recommendation to `section' the patient into a psychiatric hospital. However, in order to complete the `section' (Mental Health Act), the patients will need to be reviewed by the Approved Social Worker or AMP within the 14 days after the medical recommendation. There is a catch 22 here whereby the AMP can't complete the section unless there is a bed available for the patients to be `sectioned' into. Since there is no bed in the trust most of the time, these patients who are acutely unwell and present a risk to themselves/others are being left in the community and continue to present a risk to themselves, public and particularly their family members.

Lately, the situation has gone worse lately when the trust has been unable to locate a bed for more than 14 days and the medical recommendation are lapsing which means the patients have remained in the community for more than 14 days and their mental health continues to deteriote since their mental health needs are not being met. It is a matter of time someone is going to get hurt and it is either a member of public or the patients themselves. This is unacceptable and dangerous considering the trust couldn't identify a bed within 14 days for patients who need immediate hospital admission to prevent harm to themselves and others. In fact, lately, we had a patient sadly passed away while waiting for hospital admission. This patient was too seen by both medical officers and was recommended to be `sectioned' into hospital. His death may not be related to his mental health but If he was to be admitted into a hospital immediately or witin a reasonable time scale, his death can most likely to be prevented.

I hope someone from the Department of Health/media is reading this and decided to do something about this. For anyone who knows anyone who is on the `waiting list', I will advise them the only way to get immediate hospital admission is through A&E since the trust will only take this seriously when they get `fined' for not able to locate a bed within 4 hours (compared to 14 days in the community). If the patient refused and is in a public place, please get the police to use their power sec 136 to convey the patient to a place of safety rather than being left in the community/family home.

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Response from Tony Harding, Director of Performance, Manchester Mental Health and Social Care Trust

We are grateful for the opportunity to comment on this issue as we have been trying hard to provide speedy access to everyone who needs a period of treatment in the hospital. We all recognise that this is a particularly difficult time for both the person needing to be in hospital and their relatives and friends, and that any delay to the admission is an added stress.

To try and ensure that there is as little delay as possible in getting into the wards, we manage the beds across the city from a dedicated bed management team.

Recently there has been some changes and disruption to the bed management team and this, combined with very heavy demand for in-patient treatment, has resulted in some delays in getting immediate access.

We have strengthened the bed management team by introducing a senior manager and we have seen a reduction in the delays in admitting people as a result.

However there are occasions when it is unavoidable that there will be people on a waiting list for admission. In these circumstances we regularly review the circumstances and needs of those patients and ensure additional support for them in the community so that their needs are met in the most effective manner until a bed can be identified in the Trust or elsewhere. Today we are looking for beds for two people.

As a Trust we really want to be able to provide the best quality of services we can and so we need to hear of any problems as early as possible. For this reason we have a range of processes in place by which staff can raise any issues in order for us to work together to manage and resolve them.

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