A delayed discharge case is when a patient is medically ready to leave a hospital but remains there for non-medical reasons. The delay can be caused by factors like a lack of available social care, insufficient community care packages, or issues with the hospital’s own processes. These delays are a major concern as they reduce hospital bed capacity, potentially leading to poorer patient outcomes and increased healthcare costs.
Delayed discharges: why it’s hard to say how many are due to social care capacity
Here’s a multiple-choice quiz. What percentage of delayed discharges from hospital are caused by lack of adult social care capacity? Is it:
a) Most of them
b) 50%
c) 12%
d) There’s no way of knowing for certain.
The answer is d): we just don’t know. You get half a point if you said c) because 12% is the most we can definitely attribute to lack of social care capacity from the publicly available data. However, you’d be forgiven for thinking it was b) or even a) if you simply read the media coverage. In December, the Royal College of Nursing was quoted as saying that there was ‘barely a spare bed’ left in NHS hospitals due to a lack of capacity in social care; while in January, the NHS Confederation was reported as saying that 20% of NHS bed capacity was taken up by patients who were only there because they ‘cannot get a suitable care package’.
“Yet we don’t know the number – because, with the best of intentions, we chose to stop asking.”
Yet we don’t know the number – because, with the best of intentions, we chose to stop asking. In 2020, NHS England stopped separating out reasons for delay between health and social care. The reasoning, based on discussions with health and care organisations, was that delays were often complex, and instead of allocating them to one or other partner, systems should take responsibility, rather than individual sectors.
The most recent data recording, introduced in May 2024, requires discharge hubs (or sometimes wards) to classify the causes of delay into one of five categories:
Hospital process (issues within the hospital’s control, such as medication or transport)
Wellbeing concerns (issues outside the hospital’s control, for example where a family has doubts about a patient’s readiness for discharge)
Care transfer hub process (most commonly where the patient’s destination has not yet been decided)
Interface process (typically where transfer plans are underway but have not yet been completed)
Capacity (where the service needed by the patient is not yet available).
Except for hospital process, all these categories include delays that are due to both the NHS and social care. For patients with stays of at least 14 days (the only publicly available measure), on average 9,309 people were delayed each day in March 2025. Of these, 3,203 delays were ascribed to ‘capacity’, followed by interface process (2,639), hospital process (1,754), care transfer hub process (1,200) and wellbeing concerns (514).
If we focus on those 3,203 capacity delays – because lack of social care capacity is often cited as a key cause of delayed discharges – the single largest reason (966 people delayed) is lack of ‘bed-based rehabilitation, reablement or recovery services’.
This covers a wide range of health and care services, some of which are commissioned by NHS trusts, some by local authorities and some jointly. Even discharge hubs would not be able to allocate them to ‘the NHS’ or ‘social care’. The same applies to ‘home-based rehabilitation, reablement or recovery services’ (502 people delayed), which again cannot be split neatly into social care or NHS.
In fact, only three of the sub-categories – lack of home-based social care services (257), lack of residential or nursing care (762), and people waiting for restart of existing social care services (63) – are solely attributable to social care. But these account for only 34% (1,082) of the 3,203 total ‘capacity’ delays and only 12% of the total 9,309 delayed patients. The real figure for social care delays will be higher because it will include some of the bed-based and home-based rehabilitation and reablement delays but is not counted.
“Yet the NHS and social care are two distinct systems, funded differently, usually commissioned differently and often with different immediate concerns.”
Author:
Into that data vacuum has emerged a range of guesses and estimates, some more authoritative than others. For example, in March NHS England told the House of Commons Health and Social Care Committee that around a fifth of bed days (note that this is a different measure to the publicly available one) lost to delayed discharge ‘are for individuals accessing adult social care packages on discharge’.
In an ideal world, it might not matter. Local systems would be working together to identify problems, avoiding blame and finding joint solutions. Perhaps most are already. Yet the NHS and social care are two distinct systems, funded differently, usually commissioned differently and often with different immediate concerns. On the NHS side, there is intense media and public concern about hospital capacity, A&E waits and ‘corridor care’. On the social care side, there is a longstanding grievance about lack of funding.
In these circumstances, it has sometimes suited both sides for lack of social care capacity to be seen as the key cause of hospital discharge delays. It allows social care to make the case for more money and deflects attention from the NHS causes of delay. This is why the headlines are tolerated, sometimes encouraged.
“It allows social care to make the case for more money and deflects attention from the NHS causes of delay. This is why the headlines are tolerated, sometimes encouraged. ”
Author:
Yet it can still rankle within social care if it is held largely responsible for a problem to which it is, in fact, only a minority contributor. There is a long and inglorious tradition of blaming social care for hospital discharge delays.
There is also irritation about the word ‘capacity’: there is plenty of capacity in care homes, says the sector (occupancy has still not quite returned to pre-pandemic level); the issue is that commissioners (in both the NHS and local authorities) are not sufficiently well organised and are unable or unwilling to pay a fair price for it.
In this difficult environment, avoiding a blame game on hospital discharge was always going to be ambitious. It’s proved to be that – and more. Time to accept reality and publish a credible official estimate of the respective responsibilities for delayed discharge of health and social care.
Today i have spent quite some time trying to get through to Sheffield Hallamshire Hospital where my daughter who is held a virtual prisoner under Castle Ward can have the extensive tests she needs on her physical health which the MH would appear to be obstructing. Elizabeth is having seizures that are frequent. Her Responsible Clinician says I am partly to blame for such seizures and there are heavy restrictions in place on just me right now visiting my daughter with 2-1 supervision and not allowed any time with my daughter to take her even in the hospital grounds. This is bullying to the extreme by Lincolnshire Partnership Trust. It is also huge neglect as all they have done is cancel referrals already made by a previous area that the new GP said I should take her to. Everything was put in the way of that at Ash Villa, the previous hospital. Now the RC has put massive restrictions in place contrary to the health and wellbeing of my daughter.
Elizabeth is going downhill. Her face was a mass of red blotches and forehead looked as though she had hit her head on the wall or door – a hard surface. Her knuckles were encrusted with scars that had obviously healed from bleeding. She said she had been injected again recently. She started having the seizures at Ash Villa and there was a cancer scare – they say tests for came out normal. I had private scans done. I sent them to various experts on disk and all said the same thing that certain images need to be closely investigated by Neurology. You can imagine how happy I was when finally she was referred to a Neurologist under United Lincolnshire Partnership Trust. On the 3 January was supposed to be her appointment. She was not taken there by the MH team. I turned up instead with the private scans I had done in a small window of opportunity because for the most part LPFT have stood in the way of all leave and visits highly restricted. It is almost as if they are trying to protect themselves or know more than they let on. There is clearly something physical wrong for my daughter to have such frequent fits. She is not being monitored for her blood oxygen levels and following each fit they give lorazepam which is extremely wrong so I have been told. If she has temporol lobe epilepsy the treatment would be different but Elizabeth is treated as though she is a MH patient and nothing else. LPFT have ignored all the screenings and all the past assessments done by Huntercombe who claimed she had high functioning Aspergers. That was back in 2017 under Enfield. It would appear that ALL the doctors seem to be protecting each other because today I have had to go to enormous lengths to write and enquire about these scans. Because of my grave concerns about my daughter’s wellbeing and safety on the MH ward (Castle Ward) Lincolnshire – no way should it be left to a team of MH professionals to film my daughter against her wishes having seizures. This is against GMC guidelines. Secondly her capacity is highly disputed. There are three flawed capacity assessments done purely for the purpose of getting rid of me as nearest relative which they succeeded in. All are heavily flawed and not in line with Principle 4 and Masterman-Lister case and they do not take into account the causative nexus. The causative nexus is highly important to see determine impairment. This has not been done, making all three capacity assessments not fit for purpose.
I finally got through to Sheffield who told me that absolutely nothing had been arranged. The person concerned when to some lengths to check and refer to a supervisor.
It is hard to trust anything the NHS does as when things go wrong there is nothing but a wall of silence and it is very hard to age any kind of justice even when someone dies as a result of negligence. There appears to be a wall of silence right now. Certain doctors (even those assigned to look at physical health) appear to be standing in the way of my daughter’s much needed physical health referrals which has been the case since we moved to this dreadful area of Lincolnshire. The word normal most certainly does not mean normal and they are depriving my daughter of the necessary physical health referral to a Neurological ward where she could have extensive tests done to determine the real reason for the fits and not rely on just observations and comments that state “it is the mother’s fault”. The reasons for my appalling treatment is because of “concerns” by her Responsible Clinician on my part and an entire MDT all acting ultra vires against their own code of conduct and treating Elizabeth as someone who has no capacity. LPFT HAVE COMPLETELY ABUSED THE MCA AND NOT GONE ACCORDING TO NATIONAL GUIDELINES. I am now a BI assessor myself and am frankly disgusted at such enormous dishonesty and in addition after all this time she has not had proper pathological tests or any psychological input. The law is failing to protect vulnerable people such as my daughter.
I have written to Pals today, the Neurological department of ULHT, care concerns (LPFT) and my MP and here are my emails below. You should not have to go to these lengths. Elizabeth agreed to go to Sheffield. There seemed to be more concern about her breaking expensive headgear which she promised not to break than her physical health and wellbeing and the necessity to have these extensive tests. This is highly negligent on the part of the NHS. ABSOLUTELY NOTHING ARRANGED FOR THE SECOND TIME as today I checked with Sheffield.
FOR THE ATTENTION OF DR S I would like an appointment to discuss my daughter’s care with you. I have today checked with Sheffield Hallamshire Hospital only to find out that NOTHING has been arranged. E is having life-threatening seizures and I visited her yesterday. I have grave concerns for her wellbeing. My daughter no longer wants to live. She was covered in red marks, she is having constant fits which ARE NOT mental health conditions. You are responsible for referring her to have extensive tests which Lynsey has agreed to have done. Why has this not been done? This matter is subject to a high court case right now. I would like to know your reasons for not referring my daughter to Sheffield or has she been referred elsewhere? I would like your reasons why a MH team should film my daughter against her wishes and that you should wish to take their word when they are not qualified to comment. I was assured by your department when I called last Wednesday that an appointment had been made and it has not as I have checked today. How can you possibly monitor my daughter when you are not there 24/7. I was also told by Sheffield to contact the GP which I have done. I would like to know the details of what exactly has been arranged.
Since moving all E’s Neurology appointments have been cancelled which is highly neglectful. She has had several accidents and her face was absolutely covered with red marks. I want my daughter to have the physical health checks she needs and under Martha’s Rule she is entitled to have this. Nothing has been arranged so I need to know all the details of the appointment to pass onto the court. Her condition in past files points to neurological not mental health. I look forward to hearing this information from yourselves and the GP. I have not had response to my emails from your department and I need that response today. Thank you. I am beginning to feel like no-one wishes for my daughter to have extensive tests done and are ignoring her physical health completely. It is also against GMC guidelines to film a patient who has said she does not wish to be filmed. Not having these tests done is preventing my daughter for being evaluated on her capacity ie the causative nexus which is subject to high court action right now. Yours sincerely
Susan A Bevis T
From: susan bevis Sent: 22 April 2024 11:19 To: PALS (ULHT) pals@ULH.nhs.uk Cc: NEUROLOGYSECRETARIESLINCOLN (UNITED LINCOLNSHIRE HOSPITALS NHS TRUST) ulh.tr-neurologysecs.lincoln@nhs.net; MARISCORECEPTION (NHS LINCOLNSHIRE EAST CCG) LECCG.MariscoReception@nhs.net; Subject: Elizabeth Bevis For the Attention of Dr S (Case Ref: VA18567)
TO WHOM IT MAY CONCERN
I need to know the full details of the referral that was meant to be done on two occasions now to Sheffield for E to have an MRI scan done under a Tesla 3 scanner. On two occasions now I have phoned sheffield because no-one is responding to my emails. No appointment has been made on two occasions now despite assurances. I therefore need a copy of the referral details as obviously I cannot go by their word. I have spent a long time trying to get through only to be assured that absolutely nothing had been arranged.
Please therefore let me know the details of the referral and if this referral has gone to another area such as Nottingham by any chance?
I look forward to hearing from you regarding this urgent matter.
When I came to Dr S clinic last Wednesday I did not have an appointment arranged and did not expect to barge in front of others. I explained that no appointment had been made for Sheffield. Two ladies (managers) came out to see me witnessed by ******* All they could do was pass messages on to Dr S. I was then assured that the necessary appointment for E to go under a Tesla 3 scanner had been made. i had explained that nothing had been arranged previously and that this was being looked into and that a referral had been made when it had not been made according to Sheffield. I am absolutely in despair to hear yet again Sheffield have no record of any appointment or referral even being made.
Please can you look into this matter and provide me with details of the appointment. It is almost as if noone wishes my daughter to go and have the extensive tests needed and are trying to play down the necessity of it all.
The seizures are life threatening, the MH team are not monitoring her blood oxygen levels properly. She is being treated in the most appalling manner. I am scared for my daughter’s life. The referral to Sheffield was meant to extensively look into my daughter’s physical health and wellbeing and yet again for the second time nothing has been arranged. I totally despair.
I need to know the full details of the appointment as under Martha’s Rule my daughter is entitled to a second opinion and this can only be achieved through extensive tests done through Sheffield.
This is now urgent. I need full details of the appointment they claim had been arranged yet no-one is responding to my emails under the Neurological department of Dr S.
Yours sincerely
Susan A Bevis
2.5 years of appalling imprisonment under the barbaric NHS where not one person takes responsibility.
Everyone working together to cover their backs in the form of MDT that goes way beyond nursing and doctors codes of conduct.
Total conflict of interest at Board level with no-one taking responsibility.
In the middle of this mess is a vulnerable person now covered in marks, scratches where she is obviously totally distressed and injected frequently, missing meals and that in itself is dangerous and to make up for missing meals is taken to the shop where she may buy crisps and snacks to compensate. At least at home she would be looked after nicely and now she no longer wishes to live so she has told myself and others who have visited her.
She is treated as though she has no capacity and is being denied her physical health assessments which have not been referred as advised on two occasions.
Absolutely dreadful situation. No accountability and these doctors try to play down their responsibilities and try to put all the blame on you as a parent/carer instead of take an interest and investigate what could possibly be the cause of these life threatening seizures. To think they are more worried about her breaking equipment she is supposed to wear on her head to monitor properly than the wellbeing of my daughter.
Then I get an email from a Ms Lowe of Marisco Medical who has said she has been told not to answer my emails because I am writing to her via her own personal email address that states NHS/ICB but I just wrote back and said that can simply copy in by cc to her personal NHS email address the correct email address as what had been given to me had emails bounce back. I do not expect to hear anything but it is good communication to point out that this is the wrong email address and copy in the correct email address surely? She is supposed to be a lead safeguarding person under the GP surgery. This is a safeguarding matter they need to be aware of as two referrals have not been done. At least instead of dismissing such concerns the person should write more clearly and then why use a personal email address in the first instance to correspond with me then now say this is wrong?
So now I have to wait several days if not weeks before I get any kind of response I have asked for ie date of referral and details of what has been arranged. Why is that so difficult when Elizabeth has given consent and it seems like NOONE wants me to know anything.
In the meantime a Ms Emily Scott who is supposed to be the Clinical Lead for Castle Ward has told Elizabeth she is moving elsewhere or words to that effect that she is being taken to see a place but noone in the family is being advised of this and so the information is via Elizabeth.
When I visited Elizabeth she clearly said she wanted to come home, she misses her cat and misses her home and family. Elizabeth has spoken more than one of staff shortages on the ward and I have this in writing.
I am the only person who comes to visit each week without fail. My visits are heavily restricted 2-1. Even a prisoner is treated with more respect.
As regards capacity I had bought Elizabeth something where it indicated there was 9 pieces in a box. I had not eaten myself and after doing all her shopping for her had no chance because the visit was 2.30 and I had two pieces from that box myself. This shows tremendous capacity for Elizabeth to question where the other two pieces were. In addition to this I had bought all the nice things she wanted me to. Food is the only comfort for a patient treated like a caged animal you would see in a zoo. In a prison warders may be present and walk up and down but do not sit there taking notes of everything being said in a small cramped room, Ms Munro describes as “spacious”. So why are they doing this – it is on order. An Executive decision or that of the Responsible Clinician who is clearly not taking into account the fact that this is not conducive to recovery. It has not been taken into account that she would like some leave after all this time and only has 45 minutes so the only other enjoyment is going to the hospital shop and even that was used as punishment for appearing hostile, the subject at the time of an interlocutory injunction. This could not go forward due to county court not having the jurisdiction.
When a responsible clinician goes down the legal route first before medical concerns this is highly negligent. Why are they filming her on the ward having seizures and trying to make out this is caused by her mother. Why dont they do the responsible thing by refer her to sheffield and for the endocrinology tests as already proven in private tests there is dysfunction.
It would seem there are no standards and those at the top also work for the care quality commission and the ICB.
All I have ever wanted is for my daughter to be treated fairly.
Sadly I have chosen to live in a beautiful area that would benefit Elizabeth but she is not allowed any meaningful contact – there is complete abuse of human rights under this area. There is no accountability.
This is displayed by LPFT – what is a just culture exactly? This is completely ridiculous and biased. Just mention a “just culture” to all the parents and carers affected right now and particularly all the patients stuck on wards for years on end whilst Trusts such as this act dishonestly. When you dare to challenge you can expect a response as follows from the likes of Ms Munro who is as unfit to write complaint responses as the doctors who carried out the flawed capacity assessments.
Here is what Elizabeth has described her experience as: “hell on earth”. This is also how parents and carers view matters, those who are affected and those who are ignored. How can there be any accountability whilst those at the top have connections with the Care Qualilty Commission? How can any members of the public have faith in the Care Quality Commission who have produced some very dismissive responses even calling themselves a “business”. I have featured this on a former blog.
The Care Quality Commission (CQC) have asked us to respond to requests you have raised with them and clarify the Trust’s position on a number of points:
You have requested an apology for the verbal threats made by Dr Khokhar where she said “I am banning you indefinitely for inciting your daughter to attack members of staff on Xmas Day”.
Following the incident on Christmas Day 2023, the Trust followed the usual incident reporting and investigation processes, as well as complying with instructions and communication from the Police. During this period of investigation, your visits to the ward to see Elizabeth were suspended in line with the Mental Health Act Code of Practice 2015 and to ensure the effective delivery of Elizabeth’s care and treatment could be prioritised. Dr Khokhar accepts that he used the word “indefinitely” and that this could be seen as inflammatory. It was used to reflect that at the point, an end date to the restrictions could not be confirmed. However, the letter sent dated 29th December 2023 confirmed that the situation would be reviewed on 25th January 2024. After subsequent review of the relevant documentation, the visiting restrictions were lifted from the 5th February 2024.
You asked about your invoice for £50 for Elizabeth’s ‘wasted’ phone contract.
As previously explained in an email on 29th Februay 2024, Elizabeth’s phone access was limited for a fixed period of time as part of a comprehensive care plan that considered Elizabeth’s human rights. This was to ensure the response to her phone use did not adversely impact her engagement with, or the efficacy of, her treatment plan. This ceased on the 5th February 2024 following a review of all of the relevant factors. Elizabeth’s phone continues to be kept securely by ward staff and Elizabeth is able to request to use her phone at any time. In addition, ward staff regularly encourage Elizabeth to use her phone to maintain contact with family.
We monitor and document Elizabeth’s phone use to ensure that she has fair and reasonable access to her phone. This details the occasions when she has been supported to use her phone and make calls and evidences that Elizabeth continues to be able to use her phone on request . On the basis that Elizabeth does continue to use her phone, we would not provide any reimbursement for her phone contract.
You said that Elizabeth’s birthday cake was thrown away.
To ensure that the limited storage space for fresh food brought onto the ward by visitors is fairly available to all patients on the ward, a new process has been put in place. This is clearly communicated to patients and their friends and relatives when they visit to manage expectations. The ward also adheres to Trust wide infection prevention and control (IPC) policies relating to food storage and consumption to ensure patient safety. Elizabeth’s birthday cake did have to be disposed of on 15th February 2024 as the expiry date had been exceeded.
You raise concerns about the size of the visitor’s room and that it was cramped which upset Elizabeth
The family room on the ward is used for visits as it affords privacy and has CCTV available which can be used to review the area, if necessary. This room is the largest room on Castle Ward used for visitors.
Subject Access Requests
In relation to the Subject Access Requests (SARs) received both for personal data relating to yourself and requesting a copy of Elizabeth’s rapid tranquilisation healthcare records, the Trust’s position remains the same as detailed in the email sent on 11th December 2023. This is because we are of the view that your request is “manifestly unfounded or excessive” as detailed in Article 12 (5) of the GDPR.
Our Records Management team did note that you subsequently attached a consent form from Elizabeth. However, this was not the correct consent form to support your Subject Access Request. Further, we continue to have concerns regarding Elizabeth’s capacity to consent, which has historically remained interchangeable with regards to information sharing. We also have continued concerns that any information shared may, in turn end up within a public forum which is outside the scope of any consent that we may gain.
We ;have provided a copy of this letter to the CQC.
Yours sincerely
Ann Munro
Patient Experience Lead
Cc Care Quality Commission (Central) Citygate, Gallowgate, Newcastle Upon Tyne
NE1 4PA
EXTRACTS FROM MY RESPONSE EMAIL TO MS MUNRO’S LETTER.
Yr Ref MHA-011217-X6F7T0
Dear Ms Munro
CEO (Sarah Connery) on the Trust’s Executive Board also works/worked as a Specialist Advisor for CQC or The Director of Operations (Chris Higgins) who works/has worked as an Executive Reviewer for CQC
Thank you for your letter of 4 April.
When you mention “The Care Quality Commission” asked you to respond. Who might that be? Could that be either of two LPFT Board Executives mentioned above by any chance? To think, all this time so it would appear LPFT have been answering on behalf of the Care Quality Commission in a defensive, almost threatening manner. What a conflict of interest! No wonder why none of my complaints have been dealt with satisfactorily and with Mr Higgins as Executive Reviewer for CQC it is also no wonder why you are rated “good”.
How can you have a CEO (Sarah Connery) on the Trust’s Executive Board who also works/worked as a Specialist Advisor for CQC or The Director of Operations (Chris Higgins) who works/has worked as an Executive Reviewer for CQC however I am talking about LINCOLNSHIRE PARTNERSHIP TRUST WHO APPEAR TO HAVE THEIR OWN LAW TO SUIT THEMSELVES.
I would like your opinion on this conflict of interest, Ms Munro.
Regarding your third paragraph I would point out this was the third time Police were called unnecessarily, all done for the purpose of threatening and intimidation however Section 9 statements were done to back the truthfulness of events on Xmas Day to cover our backs. What a waste of Police time. It is obvious that the restrictions are still ongoing with HCA’s/nurses writing notes during visits (no doubt of an adverse nature). This is bullying to the extreme to stop visits and threaten to do so indefinitely but still continue with restrictions. You might like to write a statement t explaining exactly what you mean by “suspension in line with the MHA Code of Practice”: Please also explain why I am being treated differently to everyone else which is discrimination.
Here is the MHA Code of Practice relevant points which were not even quoted in full as a reason to ban my visits.
MHA CODE OF PRACTICE
Restrictions or Exclusion on Clinical Grounds
11.14
From time to time, a patient’s Responsible Clinician may decide, after assessment and discussion with the MDT, that some visits could be detrimental to the safety or wellbeing of the patient, the visitor, other patients or staff on the ward.
In these circumstances, the Responsible Clinician may make special arrangements for the visit, impose reasonable conditions or, if necessary, exclude the visitor. In any of these cases, the reasons for the restriction should be recorded and explained to the patient and the visitor, both orally and in writing (subject to the normal considerations of patient confidentiality). Wherever possible 24 hour notice should be given of this decision.
Restriction Or Exclusion on Security Grounds
11.15
The behaviour of a particular visitor may be disruptive in the past, to the degree that exclusion from the hospital is necessary as a last resort. Examples of such behaviour include:
Incitement to abscond
Smuggling of illicit drugs or alcohol into the hospital or unit
Transfer of potential weapons
Unacceptable aggression
Attempts by members of the media to gain unauthorised access
11.16
A decision to exclude a visitor on the grounds of their behaviour should be fully documented and explained to the patient orally and in writing.
Where possible and appropriate the reason for the decision should be communicated to the person being excluded (subject to the normal considerations of patient confidentiality and any overriding security concerns.
LPFT ARE IN BREACH OF THE MHA CODE OF CONDUCT RE: THE FOLLOWING POINTS:
“may make special arrangements for the visit” : No special arrangements were ever made and contact severely restricted by taking the phone away that affected the entire family and was detrimental to Elizabeth – depriving her of her phone deprived her of contact with everyone else in the family and was done primarily to punish me and deprived Elizabeth of listening to her music. This is in breach of human rights and totally degrading and undignified to Elizabeth..
“the reasons for the restriction should be recorded and explained to the patient and the visitor, both orally and in writing”.: None of this was done properly explaining the grounds mentioned below for banning visitors. No Impact assessment carried out as should have been.
“subject to the normal considerations of patient confidentiality). Wherever possible 24 hour notice should be given of this decision” This was not done. The pre-arranged visit was cancelled on the spot whilst Elizabeth stood the other side of the door – absolutely degrading and totally cruelty to do this without any notice. Nursing staff acting ultra vires upon orders at Executive level and against their own code of conduct.
None of the above was done properly and also LPFT failed to carry out an Impact Assessment which LPFT is supposed to do under NHS Guidelines and this should have been done on myself, on Elizabeth and a copy sent to the Nearest Relative. LPFT are therefore in breach of NHS Guidelines. Here below in bold are the justified reasons to completely ban visitors according to MHA Code of Conduct.
Incitement to abscond
smuggling of illicit dugs or alcohol into the hospital or unit
Transfer of potential weapons
Unacceptable aggression
Attempts by members of the media to gain unauthorised access
None of the above apply in my case.
Dr K cannot very well deny threatening me with an indefinite ban as this was witnessed. Having such a ban has had a detrimental affect on my health. Elizabeth’s face is covered in marks where she is distressed and has been self harming and has said on more than one occasion she no longer wishes to live which in turn affects my health. The missing of meals has continued beyond the last safeguarding and had happened constantly at Ash Villa in the past yet nothing was done. It is bullying to the extreme to ban visitors and that is the tactic that LPFT adopted. My visits were suspended on none of the grounds above. Elizabeth’s care and treatment has been atrocious. She has been missing meals, isolating in her room because she cannot stand the noise. She has been deprived of proper pathological tests and nothing has been arranged as regards Sheffield as I have checked. There is no way a MH team can do proper pathological observations and have been filming my daughter when she is having fits against her wishes. This is an absolute disgrace. The way the MCA has been abused is another disgrace on the part of LPFT who enlisted the assistance of the council in this respect at County Court that lasted months and months on end. Human rights are non existent under LPFT and have never taken into account of. My daughter’s human rights are being dreadfully abused. It is not true when you state visiting restrictions were lifted from 5 February 2024. Restrictions are very much ongoing and visits are not of quality time but intrusive and degrading due to constant supervision. I am being discriminated against because other family members do not have 2-1 restrictive visiting with members of staff writing notes. The restrictions still very much in place clearly have a detrimental affect on my daughter who is treated like a prisoner. She reacted on Xmas Day to staff taking notes constantly. Even on Xmas Day, human rights were ignored by LPFT. How would any of you like this kind of treatment? It is breach of Art 8, Art 5 and Art 3 HRA. Police time was wasted on Xmas Day and Elizabeth was thrown into seclusion and rapidly tranquilised when she became upset by a crowd of “professionals” waiting outside the visitor’s room who grabbed hold of her because she had shouted at the lady writing notes because it was totally distressing to her.
There have been two accidents apparently according to Elizabeth, one at Ash Villa and another on Castle Ward where she lost balance or hit her head badly. Why wasn’t anyone in the family notified?
Because we pay a phone bill each month and Elizabeth hardly gets any use of the phone it is only fair that LPFT compensates for this. The bill now stands at £60 for your information and I request settlement of this amount to Elizabeth as already advised. Every month she is restricted with her phone I am adding on to that bill. Also under Ash Villa the phone was taken away for weeks on end making it difficult for the entire family to get through and for Elizabeth to be able to speak to family members. The reason for this was because Elizabeth kept calling the Police in distress. It says so in file papers.
“Elizabeth’s phone continues to be kept securely by ward staff and Elizabeth is able to request use of her phone at any time.” That is in breach of human rights. Totally degrading treatment – shame on you LPFT! Is this care? or rather is it abuse of a vulnerable person and their rights – it should be the least restrictive care under the MH LPFT are abusing patient’s rights and if this is just my daughter then this would also come under the Equality Act 2010. No other patient is being treated in such a degrading manner as my daughter. It is not the point that she is encouraged to use her phone. She is not at risk from anyone in her family and therefore the restrictions are excessive and the kind of thing that would apply to a restricted prisoner not a patient under the MHA.
LPFT haven’t got a clue when it comes to human rights and this is why I am copying in the British Institute of Human Rights. To keep the phone locked away constantly is a disgrace and still ongoing to date. Elizabeth does not like the phone being monitored and she expressly said she did not want to be filmed so why has this just gone ahead?
You clearly do not know the meaning of “fair and reasonable” . Elizabeth is a grown adult of 37 years of age and does not need support to use her phone.
The Birthday cake was not given to Elizabeth on her Birthday and should have been given to her immediately as I specially came back to the ward. It was her Birthday and no respect was given to this special occasion. Elizabeth did not even know I had brought her the Birthday cake so once again there was no communication. At Ash Villa all her presents were just dumped in a storage room. She did not know they existed. I brought another cake to make up for this and again Elizabeth was not given it. The second time it was not fresh cream and I assume thrown away.
Yes, the visitors room is cramped when 2 people are listening to every word and crammed into the room. It is undignified and unpleasant to say the least. How can you possibly say the visitor’s room affords privacy in the circumstances. You just have no insight into the situation. The rooms are all small in nature – not much difference in size but because of the restricted visiting and note taking going on (no doubt adversely against me), it is an unpleasant degrading experience that even a prisoner does not have to endure. In a prison, warders walk up and down but give respect to prisoners at visiting times to have privacy to see their families. The ward is worse than prison and the treatment is degrading, abusive and aimed no doubt as punishment towards me, but inflicting upon my vulnerable daughter.
Subject Access Requests.
I know LPFT do not want me to see any records especially not the copy of the CP11 rapid tranquilisation log. All the files and notes being taken will be requested through ICO. You have no right to refuse such request from both of us.
Your capacity assessments are totally flawed. I want full safeguarding done externally because in the past safeguarding under LPFT resulted in “I am satisfied” response. The safeguarding should be especially looking into the flawed capacity assessments. I am now a BI assessor – everything LPFT has done is wrong. Your capacity assessments are not fit for purpose. LPFT have abused the MCA. It is most certainly of public interest that everything is addressed openly and transparently.
Finally, please ensure that my daughter gets all the pathological tests she needs under Sheffield as soon as possible as this is another area of safeguarding that needs to be thoroughly looked into. I believe safeguarding should be done on the deprival of medical referrals to my daughter for her physical health and referrals need to be made to spend a full week under Sheffield for everything she needs, including Endocrinology
I have to say, I have never encountered such bullying in all my life and such dishonesty. You have been rating yourselves as good yet there are tremendous conflicts of interest I have witnessed at Executive level.
The capacity assessments are useless without referral to Sheffield and according to Professor Keith Brown everyone should be included (including myself) with the capacity assessments undertaken. My daughter most certainly has capacity and she is being abused and no-one cares otherwise this situation would not have been left to continue for so very long.
Here are the guidelines to filming patients against their wishes:
Keith Brown. Editor. Demystifying Mental Capacity: A guide for health and social care professionals (Post-Qualifying Social Work Practice Series). First …
Mental Capacity Act 2005 :
(Section 4): Requires that patient to be regarded as having capacity until evidence ascertained as to how that capacity is impaired.
(Section 4) (1) (a) and (b): “The Prohibited Step” Decision maker should not draw conclusion on capacity from patient’s age, appearance or on a condition of his/hers or an aspect of behaviour which might lead others to make unjustified assumptions on what might be in his/her best interests.
(Section 4) (2): Decision maker should try to identify all issues most relevant to the individual relating to particular decision (para 3, Main Code of Practice).
(Section D): inconsistencies of witness statements on capacity. Capacity assessments not conducted as required by S1 MCA 2005
Masterman-Lister v Brutton & Co [2003] 1WLR 151
“a party to legal proceedings is capable of understanding, with the assistance of such proper explanation (in broad terms and simple language) from legal advisers and other experts as the case may require, the matters on which their consent or decision was likely to be necessary in the course of those proceedings.”
Dont bother providing a copy to the CQC as LPFT are the CQC defending yourselves and rating yourselves as good when in actual fact you should be rated as “Requires improvement” or “inadequate” and you can’t even offer an apology for the shocking abuse of my daughter and her family in terms of human rights which you clearly have no insight of.
My final question to you is have LPFT applied for DoLs and in the meantime waiting to hear from the court because your intention is to dump her into a care home out of area in say Yorkshire and restrict contact forever? Why is she still held without leave under the MHA for over 2.5 years deprived of family contact and proper physical healthcare? I would like to hear from any of you in this respect as this is absolute abuse and breach of the law and the question needs to be asked about the validity of the entire section that is ongoing and the dishonesty in arriving at such decisions to hold her a prisoner indefinitely. My daughter is one of thousands trapped under the MHA by appalling Trusts such as LPFT and dishonesty too on the part of Councils who do not wish to provide any support whatsoever in the community. In fact I was not asking for anything of this area which brings me to the question of residency status and whether that responsibility still remains the responsibility of Enfield?
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Psychiatric Abuse UK 