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    achimova1

    I concur with with what Dr Skinner has said. There is no way around it – more beds are needed. It is now 15 years since I have been able to get a bed for a suicidal patient in a public hospital. I am never told there are no beds – it’s always that the patient doesn’t meet the criteria. How come the patients met the criteria during my previous 20 years of practice? And why in this time of evidence-based medicine can we not get accurate figures on what happens to those who are turned away? Yes there’s the occasional bad-news story, but where’s the hard data – or is it not collected? (this being the best way to not know what we don’t want to know). The Background Briefing programme on Emergency Mental Health which featured Dr Paul Linde, an emergency room consultant in San Francisco, is worth a read, including the following: “….I wanted to talk a little bit about the No.1 problem that we see… that is people who in the lingo where I work the mantra is – ‘If you want to stay, you have to go’ …..”

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  2. 2
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    Doctor Whom

    Unfortunately some of the health reform rhetoric is crude populist nonsense.

    I’d rather be on a trolley in A&E for 6 hours with a team close by than in a ward with one nurse up on the fifth floor within 4 hours. Lets face it a trolley is only a bed with wheels – I’ve never noticed a hospital bed was any more comfortable than a trolley – maybe a bit wider.

    Part of the solution can be within the hospital and to do what others have done and set up something like a “A&E General Admission ward” controlled by A&E with a dedicated team. The team can then assess people adequately in this ward – many being discharged without going further – and if needed arrange for admission to specialist wards appropriately after assessment by the specialist ward teams.

    This works well and also has the advantage of minimising the inappropriate admissions to specialist wards and shifting patients around.

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