Tuesday 4 December 2007

Day Hospital

Should we have one?

The case against is compelling.

Our day hospital has oodles of staff treating very few of my patients. Not much bang for our buck. If the staff were in a Community Mental Health Team they'd be seeing about 4 to 5 times as many folk.

What does a Day Hospital do that a CMHT and social service day centres and EMI nursing homes can't do, if NHS staff visit and work within them?


Disillusioned said...

From my perspective, it provides a structure to days which seem unbearable...
It also tends to provide provision which remains even if a worker is off sick. OK, you would lthink that staff on long term sick leave would be covered, but not in my experience - it seems perfectly justifiable, apparently, to ignore provision stated on CPAs if the whim of the CMHT is not to provide it...

The Shrink said...

I guess my thoughts were that structured day care can happen outside of NHS day hospitals and it happens for half the cost so folks get to go more often and get more support.

In areas it's been tried it's been received by patients as better than the old day hospitals so everyone seems to win.

Nationally day hospitals are being closed down since patients favour alternatives and staff can do more if they're pulled out of them.

If the choice is day hospital or nothing, I'd want a day hospital. If the choice is day hospital or x2 as many days in a social services run day centre that NHS staff (CPNs) reach in to, along with an expanded CMHT (as day hospital staff are absorbed in to it) then the choice becomes more appealing.

Your comments on CMHT and sickness prompted a whole new post!

Disillusioned said...

Thanks, shrink. Have responded there too.

Have had experience of a Day hospital back in York in the 80s - found it fantastically helpful. that one was set up for full time use, as I believe those in my currenta rea are. It may be a different matter with day hospitals for MHOP patients. I don't know. I do wish I had been offered the support of our local day hospital when things were at their most grim for me last summer. I agree totally about choices. I also know I am coming from a very jaded and disillusioned standpoint, though my current CMHT are fantastic and are providing ten times the support I was getting with the previous one. frightening that two teams in the same Trust can be so totally different, imo. Maybe parity of provision is what is really needed - and meeting the needs of patients rather than trying to get the patient to fit what you are willing to provide.