Rise in mental health patients sent hundreds of miles from home for treatment 'hugely concerning', experts say

Exclusive: NHS spends £83m treating people out of area

Alex Matthews-King
Health Correspondent
Thursday 21 December 2017 01:56 GMT
Laura Nuttall was 16 when she was sent more than a hundred miles from home for treatment spanning seven months, her birthday and Christmas
Laura Nuttall was 16 when she was sent more than a hundred miles from home for treatment spanning seven months, her birthday and Christmas

Mental health groups have said a significant increase in the number of mental health patients being treated miles away from home is “hugely concerning”.

Patients who have spent birthdays and Christmas a five-hour drive from their loved ones told The Independent that it made the already “scary process” of being admitted even harder.

They added it was also a “totally counterproductive” use of NHS funds as private facilities are generally the only place with spare capacity.

In April 2016 the Government said that by 2020 it would eliminate inappropriate out-of-area placements (OAPs) where patients can’t be seen locally.

But analysis by The Independent of the first 12 months of NHS reported data shows that it has become more reliant on the practice.

It shows that at the end of October 2017, 710 patients were being treated away from their local trust compared to 504 patients back in November 2017 – the first full month of reporting.

But the number of inappropriate placements rose as high as 885 patients in August this year.

In total the NHS in England had 7,615 inappropriate OAPs in the 12 months to October, a significant jump on the 5,876 identified by analysis from the British Medical Association in 2016/17, before reporting began.

This amounted to a total of 215,595 days, sometimes spent away from friends and family, and at a total cost to the NHS of £83m.

While some OAPs occur because patient needs a specialist service, 95 per cent result from a lack of beds locally rather than it being the best treatment option.

Mental health groups warned this can have a negative impact on patients’ recovery and “places an enormous burden” on their carers.

This is the experience of 27-year old Laura Nuttall, who has twice been sent more than a hundred miles away for care.

“The first time was around two years ago, I live in Lincolnshire and I was hospitalised into an NHS funded bed, in a private hospital in Manchester,” she said.

“But when I was 16 I had to go down to Kent and had to stay there for seven months, I spent my birthday and Christmas there.

“Having family nearby is a really important thing, at the time we were really fortunate that it was possible to be admitted – I needed it to stay alive.

“But being admitted is such a scary process, knowing that your family can’t just come and visit when they want makes that harder.”

While the Government has recently announced plans for mental health support in schools, and a four-week wait target for under 18s, the realities of funding put that at risk.

Earlier this year Labour accused the Government of “empty promises” after NHS Clinical Commissioning Groups figures showed half the groups in England expect to spend proportionately less on mental health.

Jeremy Hunt claims mental health provision is improving

The October figures show there were also more patients sent more than 100km (62 miles) away; 385 compared to 204 November last year.

Forty patients in October were sent nearly 200 miles away, and more placements lasted more than a month – 140 patients, up from 13 last year.

Laura, who has a condition known as schizo-affective disorder, said when she was hospitalised in Kent she needed one-to-one supervision, 24 hours a day, with a nurse or staff member sitting with her while she slept.

Alongside her medication this could only happen in a mental health facility, but it also means patients are cut off from their family.

Over Christmas she did spend a few hours with her dad, but this was only possible because he could make the five-hour journey.

“Christmas for him was ten hours driving, it’s not ideal,” she told The Independent.

Other patients, from as far away as Ireland, didn’t have anyone who could drive to visit them.

Laura is now training as a mental health nurse, and has a YouTube channel where she talks about her experiences, as well as highlighting the help she’s had from mental health staff.

She told The Independent that as nurses they are taught the importance of involving families and carers in the decision making and treatment of mental health.

Last month NHS trusts were issued with new national standards to cut out of area placements, these will also place more emphasis on community based care and mental health crisis teams.

Sophie Corlett, director of external relations at the mental health charity Mind, said: “With the Government and NHS committing to putting an end to out of area care by 2021 as part of their five-year plan for improving mental health services, it’s hugely concerning to see the number of people being treated out of area going up and not down.”

This was echoed by Dr Ranga Rao, the Royal College of Psychiatrists’ national lead for acute in-patient care, who said: “On the face of it, these figures are worrying.

“Patients should only be sent away from their local area for care if it is in their best interests or in exceptional circumstances, otherwise it can have a negative impact on their recovery and place enormous burden on carers.”

A Department of Health spokesperson said: “It is completely unacceptable for patients to be sent away from their family and friends for treatment – that is exactly why we’ve committed to end inappropriate placements by 2020.

“We have legislated to put mental and physical health on an equal footing and we’re going to make sure it happens by reforming outdated mental health laws and introducing waiting time targets to improve standards of care.”

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