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I would add to Dr Davidson's observations that loss of inpatient resources has also seriously afflicted Old Age Mental Health Services in many parts of the UK. In my own service there has been a reduction of around 40% in bed numbers over the past 15 years. An unintended consequence of this efficiency-driven reorganisation is that the concentration and complexity of psychiatric morbidity and co-morbid physical frailty amongst the smaller number of patients who are now admitted has increased greatly, without there being a fully corresponding increase in the quantity and quality of expertise amongst the inpatient clinical teams or of the physical environment of wards.
Commissioning decisions are clearly partly responsible for this but we must all share some responsibility for not helping to promote a sufficiently well informed model of inpatient pathways that would have helped better decisons to be made.
Re: Too many psychiatric beds have been lost
I would add to Dr Davidson's observations that loss of inpatient resources has also seriously afflicted Old Age Mental Health Services in many parts of the UK. In my own service there has been a reduction of around 40% in bed numbers over the past 15 years. An unintended consequence of this efficiency-driven reorganisation is that the concentration and complexity of psychiatric morbidity and co-morbid physical frailty amongst the smaller number of patients who are now admitted has increased greatly, without there being a fully corresponding increase in the quantity and quality of expertise amongst the inpatient clinical teams or of the physical environment of wards.
Commissioning decisions are clearly partly responsible for this but we must all share some responsibility for not helping to promote a sufficiently well informed model of inpatient pathways that would have helped better decisons to be made.
Competing interests: No competing interests