- New data reveals more than one thousand mental health beds are still located in dormitory-style wards
- Patients report feeling “distressed”, “unsafe” and “intimidated”.
- NHS England says the government must factor this in when determining future capital budgets
NHS England says the government should consider hundreds of mental health patients who are being treated in “distressing” dormitory-style wards when it determines future capital spending budgets.
The national commissioner was responding to data obtained by HSJ, which suggests there are currently around 1,176 beds within shared accommodation style wards in use by NHS mental health trusts.
This accounts for around 7 per cent of all NHS mental health beds, covering around 300 wards.
According to the data, which was collected and shared by the Care Quality Commission, Leicestershire Partnership Trust and Greater Manchester Mental Health Trust have the highest number of beds within dormitory wards, with 166 and 134 respectively.
Speaking with HSJ patients and staff have described their experiences of dormitory wards. One woman who was admitted to a shared unit run by Barnet Enfield and Haringey Mental Health Trust in 2016 said she felt “unsafe” within the dorm and would “rather die than go back.”
One nurse working across mental health wards in Manchester, speaking on the condition of anonymity, said he felt “ashamed” when showing patients into dorms, and has seen some patients “absolutely terrified to leave their bed space”.
Many mental health trusts are unable to replace these wards with more appropriate facilities due to national constraints on capital funding.
The CQC’s mental health lead told HSJ earlier this year that guidance had stated since 2000 that new mental health wards should be single rooms with an en-suite bathroom, and that this should now be the case for all.
NHS England said: “It will be important these considerations are factored into the government’s forthcoming spending review that will set future NHS capital budgets.”
|Trust||Total number of dormitory wards||Total number of beds|
|Leicestershire Partnership Trust||39||166|
|Greater Manchester Mental Health Trust||35||134|
|Derbyshire Healthcare Foundation Trust||36||130|
|Essex Partnership University FoundationTrust||18||76|
|Sussex Partnership Foundation Trust||22||71|
According to the CQC’s figures, 763 of the beds are on adult acute wards and psychiatric intensive care units; while 429 beds are for older people with mental health needs.
Paul Lelliot, deputy chief inspector of hospitals and lead for mental health at the CQC, said the regulator would be monitoring how trusts mitigate the negative impact of dormitory wards and take action where inspectors believe more could have been done.
He added: “Removing all dormitory accommodation will be costly, and for some providers it will take time. However, we would expect every provider to have a credible plan to eliminate dormitories by a stated date and to have made every effort to secure the money to achieve this. Where capital is the barrier then we will be assessing what steps providers are taking to obtain that funding.”
Earlier this year HSJ revealed only two thirds of mental health trusts had bid for capital funding from their sustainability and transformation partnership.
A spokesman for Derbyshire Healthcare FT said: “The trust is reviewing its estates strategy and exploring ways to improve our facilities and to provide inpatient care through individual rooms. However, without substantial investment it would not be clinically or operationally viable to achieve this within our current estate without significantly reducing the number of beds we are able to provide.”
The deputy chief executive of NHS Providers, Saffron Cordery, said: “Trusts know that this is not the most appropriate setting for treating patients who are often very distressed and in unfamiliar surroundings…
“Many trusts have commissioned reviews of their mental health estate as well as seeking advice on redesign – but, of course, this requires significant financial investment.”
A spokeswoman for the Department of Health and Social Care said future capital spending budgets for the NHS would be confirmed at the 2019 Spending Review, and it accepted recommendations from the review of the Mental Health Act that capital investment will be needed to upgrade the enviroments of mental health wards.
This story was updated on 25 June at 12:27 after HSJ recieved the corrected number of dormitory wards and beds from the Care Quality Commission for Derbyshire Healthcare Foundation Trust, which had origionally supplied the regulator with incorrect figures.
“I’d rather die than go back there”
Rivkah, admitted to St Anns hospital run by Barnet, Haringey and Enfield Mental Health Trust in 2016, said: ”I was admitted late at night and it was very loud and intimidating.
“Although I was first admitted to a single bedroom, I was then forcibly moved to a dormitory even though the staff knew the distress that noise caused for me. They put me in a room with three other patients with only a curtain to divide the beds.
“I had no peace, quiet or privacy as the other patients on the dorm were very unwell and loud and nobody was trying to support them. One walked up and down the dorm all day and night repeating the same sentence. The main light could be turned on and off by anyone at any time and the door to the actual dormitory was usually left open. I couldn’t sleep. I was in total distress, being in a noisy place, where I had no door I could shut to keep noise out and no feeling of safety…One thing I can say is that I’d rather die than go back there.”
Hollie, admitted to Worcestershire Health and Care Trust’s assessment ward in 2017, said: “It was very odd, for someone that was acutely distressed and acutely unwell, being thrown into this situation, I was unfamiliar with, was really difficult to manage on top of everything else as well.
“I was sharing a dorm with a lady who was outwardly responding to voices all night. Obviously, that was not her fault, she was acutely unwell. But I was poorly too. That was really, really, difficult, even little things people coming in and out for observations.”
“It feels uncomfortable to be in a space where other people around you are so distressed. It’s not just trivial things like noise, its distressing.”
Healthcare assistant, currently working within mental health wards across Manchester, told HSJ: “When you have wards with a high number of patients who all share dorms, wards become the opposite of clean, calming, safe and secure places: They become loud, unsafe, highly stimulating places, harder to keep clean and where privacy is minimal and fear/anxiety/agitation sees more of an incline. Sadly, I work in the latter environment and I see first hand how it can be a massive detriment to a person’s recovery.
”I understand it’s not my fault, but I feel slightly ashamed when I have to show a new admission to a dorm where he/she may spend the next six months of his/her life…Staff who work on dorm based wards have the added pressures of dealing with various issues/incidents that shared bed areas can cause which causes a massive hindrance to the support they should be providing.
“I’ve seen patients who are absolutely terrified to leave their bed space because of other patients who they share a dorm with. I’ve also seen patients come to the ward and within the first couple of hours end up discharging themselves because they can’t deal with having to share a dorm room with such a diverse mix of people with varying illnesses.”
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Information obtain by HSJ
- BARNET, ENFIELD AND HARINGEY MH NHS TRUST
- Care Quality Commission (CQC)
- DERBYSHIRE HEALTHCARE FT
- Essex Partnership University Foundation Trust
- Finance and efficiency
- Foundation Trust Network (NHS Providers)
- LEICESTERSHIRE PARTNERSHIP NHS TRUST
- Mental health
- NHS England (Commissioning Board)
- Patient experience
- Patient safety
- Policy and regulation
- SUSSEX PARTNERSHIP NHS TRUST
- WORCESTERSHIRE HEALTH AND CARE NHS TRUST