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| NHS cracks down on mental health patients being sent out of area | NHS cracks down on mental health patients being sent out of area |
| (about 17 hours later) | |
| Thousands treated away from home region in practice seen as expensive and potentially harmful to vulnerable people | |
| Denis Campbell Health policy editor | |
| Mon 13 Nov 2017 00.01 GMT | |
| Last modified on Mon 27 Nov 2017 13.53 GMT | |
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| Mental health trusts are being forced as part of an NHS England crackdown to reveal how many patients they are sending elsewhere for treatment because they have too few beds. | Mental health trusts are being forced as part of an NHS England crackdown to reveal how many patients they are sending elsewhere for treatment because they have too few beds. |
| Health service bosses want to compel the 54 NHS mental health trusts in England to start publishing details every month on the number of adults they have to arrange inpatient care for outside their own area. | Health service bosses want to compel the 54 NHS mental health trusts in England to start publishing details every month on the number of adults they have to arrange inpatient care for outside their own area. |
| Mental health campaigners have condemned out-of-area placements, in which people can be sent hundreds of miles from home to be treated, as a scandal that damages patients’ health. Last year almost 6,000 patients in England were sent elsewhere – up almost 40% in two years. The cost of the practice to the NHS jumped 47%, from £108m in 2014/15 to £159m in 2016/17. | Mental health campaigners have condemned out-of-area placements, in which people can be sent hundreds of miles from home to be treated, as a scandal that damages patients’ health. Last year almost 6,000 patients in England were sent elsewhere – up almost 40% in two years. The cost of the practice to the NHS jumped 47%, from £108m in 2014/15 to £159m in 2016/17. |
| Charities, patients and families affected say such placements are unacceptable and are likely to leave patients undergoing a mental health crisis feeling scared, vulnerable and alone. Doctors have also warned about the risk of patients being “shuttled around the country”. | Charities, patients and families affected say such placements are unacceptable and are likely to leave patients undergoing a mental health crisis feeling scared, vulnerable and alone. Doctors have also warned about the risk of patients being “shuttled around the country”. |
| Last year, patients from Oxford were obliged to travel 532 miles to Inverness in the Scottish highlands to be cared for in the city’s New Craigs hospital and 497 miles to Cornhill hospital in Aberdeen, and some from Dorset went 323 miles to near Darlington in County Durham. | Last year, patients from Oxford were obliged to travel 532 miles to Inverness in the Scottish highlands to be cared for in the city’s New Craigs hospital and 497 miles to Cornhill hospital in Aberdeen, and some from Dorset went 323 miles to near Darlington in County Durham. |
| NHS Improvement (NHSI), the health service’s financial regulator, is introducing the new duty to give regular public updates to help achieve the government’s aim of ending the practice by 2020/21. “These placements are bad for patients, they are often done at the last minute and they cost more for the NHS, so [the move] will help trusts stay on track financially,” an NHSI spokesman said. The change will be contained in the agency’s updated “single oversight framework” document, published on Monday, which spells out NHS trusts’ obligations. | NHS Improvement (NHSI), the health service’s financial regulator, is introducing the new duty to give regular public updates to help achieve the government’s aim of ending the practice by 2020/21. “These placements are bad for patients, they are often done at the last minute and they cost more for the NHS, so [the move] will help trusts stay on track financially,” an NHSI spokesman said. The change will be contained in the agency’s updated “single oversight framework” document, published on Monday, which spells out NHS trusts’ obligations. |
| Welcoming the agency’s move, Jeremy Hunt, the health secretary, told the Guardian: “No patient should be sent away from their family and friends for treatment when they are seriously unwell. It wouldn’t happen with physical health and we shouldn’t accept it for mental health. That’s why I’m personally committed to ending the practice by 2020. | Welcoming the agency’s move, Jeremy Hunt, the health secretary, told the Guardian: “No patient should be sent away from their family and friends for treatment when they are seriously unwell. It wouldn’t happen with physical health and we shouldn’t accept it for mental health. That’s why I’m personally committed to ending the practice by 2020. |
| Under existing NHS guidelines, “patients should be treated in a location which helps them to retain the contact they want to maintain with family, carers and friends, and to feel as familiar as possible with the local environment.” However, chronic bed shortages can make that impossible. | Under existing NHS guidelines, “patients should be treated in a location which helps them to retain the contact they want to maintain with family, carers and friends, and to feel as familiar as possible with the local environment.” However, chronic bed shortages can make that impossible. |
| NHSI said ending the practice would also improve patients’ safety and make people less likely to harm themselves. | NHSI said ending the practice would also improve patients’ safety and make people less likely to harm themselves. |
| “Sending acutely unwell people long distances for mental health inpatient care causes major distress for people and their families, coupled with high financial costs for to NHS. Ending this practice must be a priority for mental health providers,” said Prof Tim Kendall, the NHS’s national clinical director for mental health. | “Sending acutely unwell people long distances for mental health inpatient care causes major distress for people and their families, coupled with high financial costs for to NHS. Ending this practice must be a priority for mental health providers,” said Prof Tim Kendall, the NHS’s national clinical director for mental health. |
| Some of the 54 trusts have stopped sending anyone for out-of-area care, Kendall said, highlighting the example of Sheffield. The NHS there used to have to pay for more than 3,000 nights of care a year in other areas, but now looks after all its patients itself, and has saved £5m by doing so. Local councils play a key role by ensuring that there is enough social care available to allow mental health patients who are fit to leave to be discharged, to free up beds promptly. | Some of the 54 trusts have stopped sending anyone for out-of-area care, Kendall said, highlighting the example of Sheffield. The NHS there used to have to pay for more than 3,000 nights of care a year in other areas, but now looks after all its patients itself, and has saved £5m by doing so. Local councils play a key role by ensuring that there is enough social care available to allow mental health patients who are fit to leave to be discharged, to free up beds promptly. |
| Areas that have high levels of out-of-area placements will receive support from mental health managers in places that have ended the practice, which also include Bradford and east London, as part of a joint programme of support involving NHSI and NHS England. | Areas that have high levels of out-of-area placements will receive support from mental health managers in places that have ended the practice, which also include Bradford and east London, as part of a joint programme of support involving NHSI and NHS England. |
| “We have clear evidence from many areas that have already transformed services and done this sustainably so that people can always access acute care locally,” said Kendall. | “We have clear evidence from many areas that have already transformed services and done this sustainably so that people can always access acute care locally,” said Kendall. |
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| Jeremy Hunt | |
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