Quick guide to submitting available bed days and closed bed days in MHSDS

As part of the re-design for MHSDS v6, two new data items were added to the MHS903 Ward Details table. These new data items capture the number of available bed days and the number of closed bed days.

This data will be important for understanding bed pressures and patient flow issues within the mental health system by understanding total bed capacity and bed occupancy when paired with data such as admissions, discharges and delayed transfers. That information will be used to support national priorities such as the early warning signs within the mental health quality framework and to provide information on the bed base for specialised commissioning.

Specialised commissioning beds need to be approved by the responsible commissioner before they are opened or closed. The bed data submitted to these data items should therefore be in line with this policy.

Available bed days should reflect permanently or temporarily staffed beds that are commissioned by the responsible commissioner. Beds should not be opened or closed without the responsible commissioners approval.

When specialised commissioning bed types are permanently closed, a service change notification form should be submitted to the NHS England national team by the relevant NHS England Retained Geographical Unit (RGU) or provider collaborative. No beds should be closed without regional agreement prior to the action.

If required to clarify commissioned bed numbers within your organisation, review the contract documentation.

The data submitted via these data items is a monthly total for the two fields.

The monthly total should be based on a snapshot of bed availability and closures at 23:59 of each day to provide consistency between providers.

Available bed days beds should reflect all permanently or temporarily staffed beds of that type within the provider.

In scenarios of extreme demand, admissions may be over 100% of safely staffed available bed capacity. This should be reported without adjusting the staffed available bed numbers to identify where occupancy is beyond the safe staffing levels.

This is not the KH03 definition which treats beds of people on leave as available if re-used and unavailable if not. Beds should be treated as available in either scenario.

Beds counted as available may be occupied or unoccupied.

Beds which are temporarily or permanently closed to admission, and unoccupied, should not be counted as available.

Closed bed days should reflect all permanently or temporarily staffed beds of that type within the provider which are temporarily closed for admission and unoccupied.

There is no lower or upper-time limit on how long beds can be reported as temporarily closed.

Where it is unclear whether a bed will reopen, they should continue to be reported as closed and periodically reviewed until it's clear the closure is permanent.

If a bed is closed to admission but still occupied by a patient, that bed should be reported as available. Only beds which are closed to admission and unoccupied should be reported as closed.

If beds are closed due to increased acuity of patients on a ward, the reduced capacity should be reflected in the relevant number of beds being reported as closed.

Beds which are permanently closed with no expectation that they will reopen should be excluded from reporting and not reported as closed in the MHSDS. When these bed types are permanently closed, a service change notification form should be submitted to the NHS England national team by the relevant NHS England Retained Geographical Unit (RGU) or provider collaborative.

It us up to providers to assess if a temporary closure has become permanent and to discuss that within the local system where relevant.

It is acknowledged that it may be difficult for providers to accurately report the number of closed bed days when the closures are for very short periods of time.

The number of available bed days plus the number of closed bed days should equal:

• 100% of the usually staffed bed days for non-specialised commissioning beds, or
• 100% of the commissioned bed days for specialised commissioning beds

When defining bed types, the responsible commissioner and those delegated to submit data will be required to use the following codes for patient admissions. For the purposes of this guidance, broadly specialised bed types will include the classifications in the table below:

These bed types are defined within the Data Dictionary and further guidance on the definitions can be accessed in the Mental Health Services Data Set (MHSDS) v6.0 Appendix 10.2 Mental Health Admitted Patient Classification Type definitions.

Non-specialised bed types will broadly include the classifications in the table below.  

These tables are only a guide. If you are not sure if a service is or is not a specialised service, consult your provider’s contract documentation with the responsible commissioners.

Where independent sector beds have been block booked by the NHS these should be included in the available and closed counts submitted by the independent sector provider at which they have been booked. ISP beds will be directly contracted for retained, and then for delegated will be "sub-contracted" by the lead provider. The organisation responsible (lead provider) for booking those beds is not required to submit the counts, in line with the responsibility on the independent sector provider to submit the inpatient activity to the MHSDS.

Unallocated independent sector beds that the NHS could in theory spot purchase should not be counted in the available and closed beds.