Mental health patients still sent hundreds of miles for treatment

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Hundreds of mental health patients are being sent hundreds of miles from home to get treatment, despite ministers branding the practice damaging and unacceptable.

Latest NHS figures show that in February 650 adults in England had to travel for inpatient treatment, even though Jeremy Hunt, the health and social care secretary, has pledged to reduce, and eventually ban, out-of-area placements by 2020.

That figure was just 50 fewer than in January and those 700 constituted the highest number since hospitals began keeping records in late 2016. It was partly explained by 55 NHS trusts supplying data to NHS Digital compared to 52 in February.

The fact that so many out-of-area placements continue has prompted concern for the patients and families involved and sparked fears that the planned abolition of the practice by 2020 may not be achieved.

“Doctors, nurses and social workers often spend many hours hunting for out-of-area beds, taking them away from other severely ill patients,” said Dr Andrew Molodynski, the mental health policy lead for the British Medical Association, which unearthed the figures. “The huge distances often involved rule out regular visits from friends and relatives, at a time when their support matters most.”

The health service regulator, NHS Improvement, has criticised the practice as “bad for patients”, because they can end up isolated and less likely to recover, and also expensive for the NHS. Patients have gone from Dorset to County Durham and one even from Oxford to Inverness in Scotland.

Hunt made clear last year that “no patient should be sent away from their family and friends for treatment when they are seriously unwell. It shouldn’t happen for physical health and we shouldn’t accept it for mental health,” adding that he is “personally committed to ending the practice by 2020”.

However, since this pledge, the number of mental health beds in England has fallen. There were 18,082 mental health beds available in January, February and March, 200 fewer than the 18,282 that existed in October, November and December 2017, other NHS Digital data shows.

Molodynski also highlighted that around a third of patients in out-of-area units spend at least three months there. In all, 220 of the 610 placements still ongoing on 30 November last year had lasted at least 90 days. “The fact that many placements continue for months is shocking and hugely damaging and distressing for individuals and their families,” he said.

NHS Providers, representing English trusts, also voiced unease at the growing numbers of patients being sent at least 100km from home. In February 2017 that happened to 217 patients, 40% of the placements that month. This February that had risen to 355 patients, 55% of placements. Saffron Cordery, its deputy chief executive, said it was “particularly worrying” that the proportion of patients displaced for at least 31 days rose from one in seven (14%) in February 2017 to one in five (22%) a year later. “No mental health trust wants to do this. We know people recover best when treated in their communities, close to family, friends and carers.”

“It’s right that ending out of area placements has been made a priority, but it won’t happen without the right resources in the right places.”

NHS England has ordered trusts to disclose how many patients they send out of area, and how long for, in a bid to understand the scale of the practice, which doctors say involves patients being “shuttled around the country”.

More positively, the most recent data show that what NHS England deem “inappropriate” out of area placements have been cut and that the number of bed days involved in those placements has also fallen.

NHS England said that out of area care no longer happened in some parts of the country and there are plans to end it altogether by 2021.

A spokesman said: “Getting people the care they need, when they need it, close to home requires not simply opening more beds but substantially increasing early intervention community services, which offer a genuine alternative to hospital admission underpinned by a clear plan, additional investment and a boost to our workforce, all of which the NHS is making progress on but none of which can happen overnight.”


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