Mental health patients still cared for miles from home

Thousands of acutely ill mental health patients are still being sent miles from where they live for treatment despite the government pledging to end the ‘harmful’ practice by April next year.

The British Medical Association findings come more than two years after the BMA first revealed how record numbers of ill patients were separated from families and local support services due to a lack of available beds in their local area.

Latest analysis found that of the trusts in England with comparable data between 2018 and 2020, 47 per cent had sent patients to what is termed ‘out of area’ beds 100 times or more in the 12 months up to August 2020. Of that, at least seven trusts doubled their number of out of area placements in the 12 months to August 2020 compared with the same period in 2017/18.

The research also revealed that very few of the Clinical Commissioning Groups which fund, and therefore set bed numbers, plan to increase local bed capacity – something which is very much needed if patients are to stop being sent miles from home for care.

The BMA concludes that it is now almost inevitable that the government will miss its target of eradicating inappropriate out-of-area placements by April of next year – a commitment NHS England gave in its’ 2016 review of mental health care. Now, the BMA estimates that at least 1,000 extra beds for mental illness are needed in order to end this worrying practice with concerns that the impact of coronavirus will only increase demand for beds.

The BMA is calling for: a credible plan to recruit and retain more staff to build up the capacity of mental health services across the country; stronger support for community mental health services; greater analysis of high out of area placement use areas to inform the urgent development of CCG level plans to both increase capacity and strengthen community services; and for trusts to ensure that the new NICE guidelines for complex psychosis (rehabilitation) are followed and that trusts have adequate rehab facilities for both community and inpatients.

Andrew Molodynski, BMA mental health policy lead, said: “We are seeing nowhere near enough progress in ending the harmful and destructive practice of sending mental health patients out of area for treatment. This unacceptable and unnecessary practice causes distress to some of the most vulnerable in society, increases the risk of suicide and separates people from their friends and family when those bonds are most needed.

“Despite mental healthcare leaders and providers all calling for an end to this practice for years now, the failure to invest in mental health beds and in good quality community care means the situation is as bad or even worsening in many trusts. Addressing this is even more urgent given the impact of the Covid-19 pandemic and the recession on the mental health of the population alongside an inevitable squeeze on public finances.

“It is absolutely crucial that the government recommits to ending this practice by delivering on the much-needed extra beds and ensuring the optimum co-ordination of services before this spirals any further out of control. A moratorium on further bed cuts, given the damage done by reductions in recent years, is now essential alongside re-provision of both inpatient and community services where there are gaps.”