Bed blocking is back and, at least in mental health, it is joint working with social care teams where the most effort needs to be applied.

Last month our analysis of the rise of delayed discharge in general acute beds indicated the old ills of delays in social care assessments and funding arrangements had largely been addressed (see 'Why bed-blocking is making an unwelcome comeback').

But the Department of Health report on delayed discharge in mental health services leaked in this week's magazine reveals a more troubling picture (see 'Blocked psychiatric beds cost£110m a year'). See also this week's magazine feature, 'Home Truths', page 24-25, 24 May.

Poor planning and liaison between health and social care teams is blocking around 2,500 beds at any one time with patients who are ready to be cared for in the community.

Meanwhile, more languish outside waiting for a place.

And for mental health staff, delayed discharge brings increased risk from patients resorting to substance misuse, self-harm and violence.

Concerns about such a miscasting of provision can only be exacerbated in the context of the national scarcity of mental health beds and increasing public focus on the effectiveness of psychiatric services.

The Mental Health Bill will expose this problem to public gaze, as NHS and social care teams struggle to meet the demands for community treatment.