title: What happens when 55% of acute psychiatric beds are closed in six days: an unexpected naturalistic observational study.
abstract: OBJECTIVE
  The sudden closure of 30 out of 54 acute psychiatric beds in Cornwall presented a stressful challenge to staff but also a natural experiment on how a service dealt with this situation. We aimed to evaluate the outcomes of patients needing to leave the closed ward, how bed occupancy rates were affected and the impact on admission rates.
  
  
  METHODS
  A service evaluation of the impact of the ward closure.
  
  
  METHODS
  A comprehensive secondary NHS mental health service in Cornwall serving 550,000 population.
  
  
  METHODS
  The destination of the patients needing to leave the acute unit, the effect of the closure on bed occupancy, admission rates and serious untoward incidents.
  
  
  RESULTS
  Of 26 patients needing to be moved from the acute ward, only 10 needed an acute psychiatric bed. None of the seven patients who had been on the ward longer than nine weeks needed an acute unit. Admission rates fell over the subsequent three months. There was no increase in serious incidents due to the closure.
  
  
  CONCLUSIONS
  This naturalistic event suggests that many patients on acute units could be cared for elsewhere, especially recovery/rehabilitation care environments, if political and financial urgency is present. Admission rates are responsive to the pressure on beds.
authors.affiliation: Cornwall Partnership NHS Foundation Trust, Cornwall PL14 4EN, UK; Mental Health Research Group, University of Exeter Medical School, Exeter EX1 2LU, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Laugharne
authors.affiliation: Cornwall Partnership NHS Foundation Trust, Cornwall PL14 4EN, UK.
authors.forename: Matt
authors.initials: M
authors.lastname: Branch
authors.affiliation: Cornwall Partnership NHS Foundation Trust, Cornwall PL14 4EN, UK.
authors.forename: Anji
authors.initials: A
authors.lastname: Mitchell
authors.affiliation: Cornwall Partnership NHS Foundation Trust, Cornwall PL14 4EN, UK.
authors.forename: Lindsay
authors.initials: L
authors.lastname: Parkin
authors.affiliation: Cornwall Partnership NHS Foundation Trust, Cornwall PL14 4EN, UK.
authors.forename: Phil
authors.initials: P
authors.lastname: Confue
authors.affiliation: Cornwall Partnership NHS Foundation Trust, Cornwall PL14 4EN, UK; Mental Health Research Group, University of Exeter Medical School, Exeter EX1 2LU, UK.
authors.forename: Rohit
authors.initials: R
authors.lastname: Shankar
authors.affiliation: Cornwall Partnership NHS Foundation Trust, Cornwall PL14 4EN, UK.
authors.forename: Diane
authors.initials: D
authors.lastname: Wilson-James
authors.affiliation: Cornwall Partnership NHS Foundation Trust, Cornwall PL14 4EN, UK.
authors.forename: Mike
authors.initials: M
authors.lastname: Marshall
authors.affiliation: Cornwall Partnership NHS Foundation Trust, Cornwall PL14 4EN, UK.
authors.forename: Maria
authors.initials: M
authors.lastname: Edgecombe
authors.affiliation: Cornwall Partnership NHS Foundation Trust, Cornwall PL14 4EN, UK.
authors.forename: Bernie
authors.initials: B
authors.lastname: Keaney
authors.affiliation: Cornwall Partnership NHS Foundation Trust, Cornwall PL14 4EN, UK.
authors.forename: Kiran
authors.initials: K
authors.lastname: Gill
authors.affiliation: Cornwall Partnership NHS Foundation Trust, Cornwall PL14 4EN, UK.
authors.forename: Juliet
authors.initials: J
authors.lastname: Harrison
keywords: inpatient care; mental health