Bed blocking unlocked20/01/17
The delayed transfer of care is a subject seldom out of the news, and the problem is becoming more acute.The most recent figures released by NHS England show 193,700 delayed days in November 2016, a big increase on the same period the previous year. This bulletin concerns patients who have mental capacity.The process for addressing those who lack it is different and we can advise on options and processes for such patients if required.
Strategies for addressing the issue vary, but the availability of suitable accommodation to move to, and the patient’s agreement to move there, is crucial. We recently supported an acute hospital Trust to gain possession from a patient who no longer required clinical support but refused to vacate (while at the same time alleging false imprisonment). The Local Authority’s housing department and Social Services had engaged fully to provide suitable alternative accommodation and support, but the patient refused to leave the hospital.
Evicting a patient is a highly sensitive, emotive issue and carries the serious risk of negative publicity even where the bed is urgently needed for new patients. In this case, our client followed the process approved by the Court in the case of Barnet PCT v X and obtained a possession order at court, but the patient still refused to vacate.
Enforcing an order for possession
The patient continued to refuse to sign a tenancy agreement for alternative accommodation that wholly met his needs, and there was a risk that the local authority would not allow the patient into occupation. Ultimately, a robust approach by the Trust, and by the ambulance service which was prepared to discharge the patient to the pavement if required, as well as a flexible approach by the local authority allowed the eviction to proceed successfully.
How we can help you
There are many aspects to manage, and we have experience of advising on all of them:
- What constitutes “reasonable force”? Does a bailiff need to be present? Who is best placed to enforce a possession order in view of the patient’s specific situation? Our client’s patient was tetraplegic, had to be dressed for January weather upon eviction and briefly restrained in his wheelchair for his transfer to patient transport.
- Risk assessment, adherence to policies, recording of all decisions relating to discharge from care up to actual eviction, together with demonstrating the reasonableness of the decision to evict, the reasons for it, and addressing potential reputation management issues.
- Working with police, local authority, social services, court bailiffs to ensure that physical removal was not followed by readmission to hospital as a place of safety.
It is no easy matter to evict patients who are reluctant to leave hospital when there is no clinical need for them to remain there.We are on hand to ensure that this difficult process is completed lawfully, to the patient’s ultimate benefit, and with the risk of reputational damage effectively minimised.