• Mental health patient left in urgent assessment unit for a week without a bed
  • One of three complaints about sleeping in chairs at the unit, amid inpatient bed shortages in Birmingham and Solihull
  • Birmingham and Solihull providers have secured an additional £8m for more mental health inpatient beds

A mental health inpatient was left to sleep on chair for a week in a unit intended to keep people for no more than 12 hours.

Birmingham and Solihull Mental Health Foundation Trust revealed the incident in a list of complaints published in its October board papers, which included several complaints about long stays in the trusts’ psychiatric decisions unit in Edgbaston.

The complaint comes amid wider concerns about a shortage of inpatient mental health beds in the West Midlands.

The board papers said all the trust’s wards “continually” had an occupancy of more than 100 per cent.

The complaint, which was upheld, said because of “bed availability” the patient spent a week in the urgent assessment unit without a designated inpatient bed and “over the course of the week she rested on a recliner chair”.

In response to the incident, the trust said any patient who spent more than 12 hours in the unit now triggered an offer of an out of area bed.

“The review of inpatient beds is an ongoing process that is reviewed frequently, every day,” the papers added.

Two other complaints listed, both of which were partially upheld, also referenced having to sleep on a chair while waiting to be admitted through the psychiatric decisions unit, in one instance overnight.

The complaints cover 2016-17, with the week long wait occurring in November 2016.

A trust spokeswoman told HSJ: “During this period there were no inpatient beds available within the trust and an out of area bed was not deemed appropriate in this case. In such cases, decisions are taken collaboratively with family members in the best interests of the patient and the trust continues rigorous efforts to source an appropriate inpatient bed. Because of the specific circumstances, the period of time spent in the PDU was far longer than anticipated or is usual for this unit.”

The trust had since apologised to the patient, she said.

A psychiatric decisions unit was introduced at the trust in 2014 with the aim of diverting urgent mental health assessment away from hospital emergency departments.

The unit has the capacity to deal with eight patients but has no inpatient beds, intended instead as a referral gateway to the other services.

A trust evaluation of the unit found its introduction coincided with a reduction in mental health presentations at A&E, inpatient admissions and bed days.

However, the Care Quality Commission raised concerns about the unit in its last inspection report in August, which rated the trust as overall as requires improvement.

The CQC said all alarm triggers in the unit must be effectively checked and maintained and patient stays should not exceed 12 hours.

The trust spokeswoman said the average length of stay at this unit between April and August ranged between 12 and 16 hours.

In February, the CQC raised broader concerns about a shortage of mental health acute beds across the West Midlands, claiming it placed patients at a “high” risk of taking their own life.

“There remains a shortage of acute beds in this trust and in other mental health trusts in this region. This shortage will continue to impact the most vulnerable people in the community,” the regulator said.

The comments were in response a coroner’s report into the death of Patricia Cleghorn, by intentional overdose, which concluded she may not have died if she had been admitted to hospital sooner.

Earlier this year, Birmingham and Solihull clinical commissioning groups approved an additional £8m over two years for 36 additional mental health inpatient beds in response to review that confirmed a shortage of beds. These beds, half of which are going to Birmingham and Solihull Mental Health FT, will be rolled out in early November.

Birmingham and Solihull Mental Health one of four trusts in the MERIT mental health vanguard.

The vanguard is also launching a new bed management system next month, to better manage patient flow and cut out of area placements across all four trusts.