'Bed blocking' in one adolescent unit costs NHS over a million

An 18-month study of 'bed blocking' in an adolescent unit in Birmingham has found that the cost to the NHS was over £1 million.

Delays in discharges, or bed blocking, are a matter of increasing concern for policy makers and clinicians. The main focus of research within mental health has been old age psychiatry, and to date there have been no published surveys of delayed discharges from adolescent units.

This is despite the fact that bed blocking is expensive and counter-therapeutic for young and old alike.

The study was carried out in Parkview Hospital in Birmingham, which has three adolescent wards covering the West Midlands region.

Discharges from the three wards were surveyed retrospectively over an 18-month period between March 2003 and November 2004. The researchers reviewed 19 cases previously recorded by the mental health team as having a delayed discharge.

It was found that the average period of delay was 126 days. One current in-patient accounted for a delay of 978 days, and was excluded from the analysis.

All cases were complex, with more than one diagnosis and multiple psychosocial issues. More girls than boys had delayed discharges.

The total number of delayed bed days was 3209, equivalent to 8.8 'bed years'. The most common reason for delayed discharge was finding a placement for the young person, and funding for primarily social factors.

At an NHS day rate of £320 per patient, the cost of 3290 delayed bed days was £1,026,880. The scale of the problem has major financial implications, and restricts bed availability for new patients.

There are particular problems with placements funded by social services that require improved working systems and communication. Young people with very complex needs often fall between health and social services, and are the hardest to place.

http://www.rcpsych.ac.uk/