Crisis in admission beds - A four-year survey of the bed state of Greater London's acute psychiatric units

Background. This study was carried out to measure bed occupancy in Greater London's psychiatric units, in response to the apparent shortage of admission beds. Method. The bed occupancy of London's 54 National Health Service (NHS) acute psychiatric units within 29 districts was ascertained by telephone on 16 bank holidays covering the period 1990-93. Results. The mean occupancy level for all London over the 4 years was 97.54% (95% Cl=+/-0.94%). The number of beds occupied in inner London was significantly greater (99.79+/-1.11%) than in outer London (95.1+/-1.49%) (t=3.85, d.f.=462, P<0.001). Bed occupancy for inner London units was greater than or equal to 100% on over 49% of occasions. There has been a steady decline in the number of beds over the four-year period. There was a clear correlation between occupancy levers and the Jarman UPA8 Underprivilege Score (r=0.504) and between bed provision and the UPA8 (r=0.67). Conclusion. Occupancy rates have become unacceptably high and require careful monitoring. Corrective action may be required in order to prevent a breakdown in services.