Under the 2014 Care Act, Jessie should be able to express a preference about where she lives.
She has mental capacity, but was assessed by the NHS as needing a professional advocate to support her in this, helping her understand the decisions she is asked to make and to explain her views to others.
Jessie was referred to an advocacy firm by the council, but in June 2024 her case was closed after she asked for a new advocate but then didn’t respond to further contact.
The health and care system is “convoluted, complicated, very bureaucratic” and it is easy for a patient’s voice to get lost, says Caroline Entwistle from the advocacy charity, VoiceAbility.
She believes an advocate can “take that pressure off the person who’s feeling quite overwhelmed” – but that funding for such services is not keeping up with demand.
The hospital did provide Jessie with mental health support while she was in her cubicle. But she believed no-one was listening to her.
“I explained all the reasons I wasn’t happy with [the accommodation],” she says, “but they just went ahead with it anyway.”
In August 2024, 16 months after she arrived, the hospital started legal action against Jessie to repossess the bed she was in.
She did not really understand what was happening, she says. Neither did her mother. They could not find a solicitor and had no advocate, so the first two hearings went ahead without anyone representing Jessie’s views.
The NHS trust argued a patient didn’t have the right to choose their placement, and that a hospital bed took up significant resource.
It said it had taken account of Jessie’s vulnerabilities throughout and the package of care offered by the council was significant, with staff present 24 hours a day to keep her safe.
A care plan, which detailed the support Jessie needed, was only given to the court at the final hearing. The date suggests the assessment was completed the day before. It also notes that “Jessie is unable to communicate effectively”.
At the final High Court hearing on 4 October, Jessie attended remotely from hospital. Within minutes she was overwhelmed and had to leave. Her mother struggled to speak for her.
The judge said Jessie could challenge the council’s assessment of whether the accommodation and care were right for her, but she could not remain in hospital “when she does not need a bed there, and has not needed one for over a year, and others do”.
He ruled that Jessie must leave hospital, and said “we must hope the transition goes smoothly”.
The hospital trust says it is committed to working with “care partners to provide the best possible care for those in our communities” in the place that “best suits their needs”.
The most recent data, from 2020-21, suggests a standard NHS hospital bed costs £345 per day. Adjusting for inflation, this would mean Jessie’s hospital stay is likely to have cost more than £200,000. We do not know how much the legal action cost.
Ten days after Jessie’s final hearing, 18 months after she arrived in hospital, the police arrested her. She spent several hours at a police station before being moved to the flat in the town that holds bad memories.
Police are investigating her for a number of alleged incidents, she told us, including for sending offensive emails shortly before she was evicted in October.
Since moving, Jessie says she has self-harmed and the police have been called on three occasions – once by Jessie, twice by staff.
“They don’t know what to do with me,” she says.
Jessie has recently been visited by a new advocate.