Bed Blocking – Difficult Decisions?

Life is full of difficult decisions and who has access to or who needs to move on from an NHS hospital bed is one of those for a Hospital Consultant and a NHS Trust to take.

In the recent case of University College London Hospitals v MB, the High Court, acting on the application of an NHS Foundation Trust, granted an injunction to force a hospital patient to move into her home. Camden Council had prepared for this for her, with accompanying 3 month 24/7 care package, for when the hospital terminated her licence to occupy her bed in the hospital. She was asked to leave but refused.

Patients have no right to occupy beds or rooms in hospitals except with the hospital’s permission and it is entitled to withdraw that permission. In doing so it should balance the needs of the patient currently in occupation against the needs of others who it anticipates may require that bed. Once the licence has been terminated the patient is a trespasser but naturally if the patient does not leave voluntarily then a court order may be needed, as it was here.

After careful and detailed consultations between the Consultants involved and liaison with the Local Authority it was assessed that this patient was fit to move to the accommodation prepared for her; it was in her interests not to be in the hospital, which was admitting Covid -19 patients and the bed was needed for those patients.

This patient was at times difficult and demanding but with significant mental health issues and she found it difficult to accept change or adapt to it and this was going to put significant pressure on her.

Was it degrading and inhuman treatment; was there a significant risk to her; was it an unacceptable interference with her right to respect for her private and family life; was it discrimination due to her disabilities? Was it, as a matter of public law, an irrational decision; did she have mental capacity to defend the proceedings and had all the necessary risk assessments been made? The Judge concluded the decision was carefully arrived at, rational, not a breach of her human rights and she had the proper capacity to defend herself.

Most of us if asked to leave hospital would have gone, without more but it is reassuring to know that if challenged the Trust has to justify itself, with care, but also, if needed, the Court, with care, will grant an injunction to free that bed for someone who needs it more, “at 12 noon tomorrow”. That was the decision and order.

Life is full of difficult decisions but it is good to learn of one taken with care and the right outcome, especially when made at such a difficult time for the NHS and the country at large.

Written by Robert Sainsbury – Bates Wells & Braithwaite – 01787 880440

Robert Sainsbury

Robert is the firm’s agricultural and commercial property lawyer. He joined Bates Wells & Braithwaite in 2003 having worked in East Anglia since qualifying as a solicitor in 1984.

Robert has many years’ experience of agricultural and commercial property work both freehold sales and purchases and the grant and taking of leases, options, promotional and overage agreements. He has given the Cambridge Law Society’s Agricultural Law up-date seminar in recent years.

In his spare time Robert spends a lot of time with his family, enjoys badminton and tennis and plays an active role within St Mary’s Church Bury St Edmunds.