A crisis in mental health care has been declared by NHS staff in East Anglia, across a region covering the constituencies of two government health ministers.
Nurses say that it has become common for there to be no beds available for mental health patients in all of Norfolk and Suffolk, leading to severely ill patients being driven hundreds of miles to hospitals as far as Manchester.
The situation has become so acute that staff, who regularly work excessive hours because they cannot leave their patients until a bed is found, are considering industrial action. In one incident, a mental health professional spent 22 hours with a patient who was eventually driven to a ward in Cheshire.
Experts say the situation is symptomatic of a national problem, and concerns for the safety of patients, staff and constituents of two health ministers has brought the crisis sharply into focus for the Government. Historically, mental health services had much lower levels of funding than physical health. Earlier this year, NHS England reduced the tariff for mental health services by 1.8 per cent, compared with 1.5 per cent for physical health.
Norman Lamb, the Liberal Democrat mental health minister, is MP for North Norfolk, which has been at the centre of the crisis. Conservative health minister Dr Dan Poulter is MP for Central Suffolk and North Ipswich, which is also covered by the trust. Concerns about mental health care at the Norfolk and Suffolk NHS Foundation Trust have mounted since it announced £40m worth of savings two years ago. The savings were a consequence of a slowdown in national NHS funding after £20bn in efficiency savings were ordered.
Since 2012, the trust has made 175 staff redundant. Despite rising demand, there are proposals to reduce bed numbers in the Great Yarmouth and Waveney areas. Staff warn that care levels have been compromised. In February, staff wrote to local health commissioners warning of "a crisis in bed availability" and "patients' safety being placed at risk and their legal rights infringed". Last week, three wards in Norfolk had to accommodate patients on makeshift beds in the ward living room after reaching bed capacity.
Emma Corlett, a mental health nurse and Unison branch spokesperson, said patients assigned an urgent mental health assessment within four hours by GPs were being assessed over the phone because staff had no time or resources to meet them. "They are effectively being phoned saying: 'Do you think you can keep yourself safe overnight?' This is obviously unsatisfactory. It's not clinical judgement that's driving that decision," she said. "It's the sheer volume of work."
Cuts to specialist outreach teams, designed to help to keep patients out of hospital and cared for in the community, had exacerbated difficulties. The trust was criticised last year at an inquest into the death of trust patient Matthew Dunham, 25, who jumped to his death from a shopping centre in Norwich. The coroner described his care as "fragmented and unco-ordinated". The trust could face similar criticism at a forthcoming inquest into a man who died after a balcony fall in Norwich in March.
Mr Lamb acknowledged that mental health services in Norfolk are "not good enough" and has met hospital regulators and the trust. He reacted furiously to NHS England's decision earlier this year to reduce mental health funding disproportionately, which he says flies in the face of government commitments to give equal priority to physical and mental health services. He says he has taken up his concerns with local trust commissioners and told by them they had since received a funding boost.
Dr Rob Harwood, of the British Medical Association's consultant committee and a senior anaesthetist in Norfolk, said the trust had forced through changes to mental health services "not seen elsewhere". "It's the ultimate irony," he said. "We have two health ministers whose constituencies are covered by the trust which is doing some things that are difficult to understand."
Mr Lamb is concerned that, nationally, commissioners are focusing spending on meeting physical care targets. He insists he stands by government health spending decisions in this Parliament, but hinted the Liberal Democrats would want to increase investment in the NHS if they remained in government.
Andrew Hopkins, the trust's acting chief executive, said: "In common with other mental health trusts across England, we have seen increases in demand for acute beds and out-of-area acute placements. We have plans in place to ensure that we will not need to use out-of-area placements in the long term."
A Department of Health spokesperson said: "There must be equal priority between mental and physical health services. The difficult economic decisions this government has taken has meant we have been able to protect the NHS budget."
Dr Poulter did not respond to a request for comment.