Specialist Trainee (ST3), Leeds Partnership Foundation NHS Trust, Child and Adolescent Mental Health Service, Leeds
Northumberland, Tyne and Wear NHS Trust, Northgate Hospital, Morpeth NE61 3BP, email: vsbadge{at}rediffmail.com
Coventry and Warwickshire Partnership Trust, Coventry and Warwickshire Hospital
Coventry & Warwickshire Partnership NHS Trust, Brooklands Hospital, Marston Green
AIMS AND METHOD
Long-term admission trends in a large specialist National Health Service (NHS) hospital were examined over a 3-year period. These were compared with three earlier 3-year periods. The medical records were examined for admission numbers, source of admissions, length of stay, legal status, reason for admission and readmission rate.
RESULTS
The percentage of patients admitted from home decreased over time, whereas the admissions from group homes increased threefold. Long-stay admissions decreased in the second and third periods followed by an increase in the fourth period. There was a progressive increase in formal admissions and a decrease in informal ones. There was an increase in admissions of people with psychiatric illness and a decrease in admissions because of social difficulties. The percentage of first admissions gradually increased and the percentages of readmissions gradually decreased.
CLINICAL IMPLICATIONS
People with intellectual disability are more likely to be admitted for psychiatric reasons and to be detained under the Mental Health Act than in the 1970s. There should be a much greater interaction between hospital and community services to facilitate shorter stays and early discharge. Out-of-area placements need to be taken account of while commissioning for the total need in a geographical area.