For those of you who don't twitter - Our take on the response from Lancashire Care

The Beds in the Orchard Campaign received its first official response from the Trust this afternoon via our Twitter account @OrchardBeds from @LancashireCare.

Here's what they had to say and, of course, our response.

@OrchardBeds The decision to operate male only beds at The Orchard is a temporary measure and is under constant review. (1/5)

We can't argue about whether or not this is true as we only have this statement from the Trust about it.  However; we do know that some Trust staff have been advised The Orchard may revert back to mixed provision once The Harbour opens in March 2015, suggesting that it is not under constant review as the decision has already been made.  We are open to concede there may have been a communication problem if staff have not been informed about it remaining male only until the opening of The Harbour.

Regardless of whether this is temporary or not, it is impacting women and families now.  It is hurting female service users now and there remains no clinical benefit to women from the closure.

@OrchardBeds There is a peak in demand for male beds & a reduction in demand for female beds - we have empty female beds at present. (2/5)

Two responses here.  Firstly, it is likely that the peak in demand for male beds is linked to the trust closing a 15 bed male ward in Burnley and it is rather disingenuous to cite demand for male beds being the driving factor after closing 15 of them.

Secondly, the point about empty female beds is slightly misleading.  The status of beds can change on an hourly basis.  From personal experience a bed can be taken in the time it takes to have a consultation with your psychiatrist about whether you should go into hospital or not.  A freedom of information request has already been submitted to the trust about how many women they've sent out of area in the last 4 years, often to private hospitals that should clarify demand.

We also directed them to this post - http://bedsintheorchard.blogspot.co.uk/2014/10/is-based-on-need-self-fulfilling.html

This isn't about empty beds.  Its about denying a whole group of service users access to local inpatient care solely based on their sex.

@OrchardBeds All Trust facilities have the ability to flex male/female beds in line with demand. (3/5)

This is indeed True.  The Orchard had two 'swing' beds that could change between male and female.  There were 10 fixed male beds and 6 fixed female beds.  Up until recently, the two swing beds were female.  The trust could have swung those beds to male, giving them 12 male and 6 female beds at The Orchard. Instead they decided to deny access to a whole group of service users from a wide area. 

It is rather disappointing that the Trust sees removing access to local inpatient care to all women in the Lancaster area as 'flexing'.

@OrchardBeds The Orchard will revert to mixed sex as soon as this is clinically appropriate. (4/5)

There's nothing we can really say about this other than, how is it clinically appropriate to deny women access to local inpatient care.  No, seriously.  Our twitter handler has replied that we will be happy to discuss this with someone qualified to explain the clinical benefits to women of sending them out of the area for treatment.

 @OrchardBeds We would be happy to discuss this further with you and you can contact us on communications@lancashirecare.nhs.uk (5/5)

One of our team had already emailed the complaints department with the letter we published here

http://bedsintheorchard.blogspot.co.uk/2014/11/not-sure-what-to-write-when-you-complain.html

We will publish their response as soon as they receive it.

Is 'Based on Need' a self-fulfilling prophecy?

A source close to the trust revealed today that the decision to close the female inpatient beds was based on a need for more male beds.

We know that there is a high demand for female beds, with women already being sent out of the area, often to Private Hospitals, such as The Priory in Manchester due to lack of capacity and a FOI request has already been sent to the Lancashire Care Trust about the number of female admissions.  Even without this information there are questions that have to be asked about this statement.

Firstly, why are there not enough male beds?  It is the responsibility of the Trust to ensure there is some slack in the system, but the planned cuts of 25% to the services provided by this trust in the coming year would suggest that inpatient care is not being covered properly.

Secondly, this looks strongly like discrimination based on sex.  Why should women be denied local access to inpatient psychiatric care due to a lack of male beds?  Are the needs of women with mental illness less important than the needs of men?  Are the needs of women to be close to their families, children and support networks less important than the needs of the men?

Moreover, is the damage caused to female inpatients by removing them from the local area, less important than providing 8 beds for male patients?   I would suggest it isn't.

This brings me onto the point of this post.  If you reduce the number of female beds, it will reduce the number of admissions, skewing the assessment of 'need'. The closure of the female inpatient service in Lancaster will also...

a. Discourage women from accepting voluntary admission, reducing the number demanding a bed.
b. Discourage women from seeking help knowing that they will be sent long distances from home, reducing the demand for a bed.
c. Discourage families from seeking help for their female relatives, knowing they will be sent away from home.

The need for local female psychiatric inpatient care is as important as the need for male beds.  Reducing access is a self-fulfilling prophecy.