Adult mental health patients in England have spent more than 200,000 days being treated in “inappropriate” out-of-area placements – at a cost to the NHS of £102m – in the year since the government pledged to end the practice.
The Royal College of Psychiatrists, which carried out the analysis, says such placements, in which mental health patients can be sent hundreds of miles from home, are a shameful and dangerous practice that must stop.
The government said it would end such placements by April last year but, in the 12 months since, 205,990 days were spent inappropriately out of area, at a cost equivalent to the annual salaries of more than 900 consultant psychiatrists, the college found.
Dr Adrian James, the college’s president, said: “The failure to eliminate inappropriate out-of-area placements is a scandal. It is inhumane and is costing the NHS millions of pounds each year that could be spent helping patients get better.
“No one with a mental illness should have to travel hundreds of miles away from home to get the treatment they desperately need.”
He said investment was needed in local, properly staffed beds, alternatives to admission, and follow-up care in the community as well as government backing “to address the workforce crisis that continues to plague mental health services”.
Rebecca Regler, 35, from south-east England, waited 14 weeks for a bed in an eating disorder unit before being admitted to a hospital in Scotland for anorexia in spring last year. She said she was devastated when she was told she was being sent to Scotland.
“Although I experienced excellent care, it was a very difficult time,” she said. “I was in hospital for nine months. That’s a really long time to be away from your family and friends and I definitely think that not being able to have visits impacts on your recovery – it has a negative effect.
“I think we need urgent ringfenced funding now. It’s not acceptable to be treated 300 miles away, and it has a huge impact on patients and their families.”
Regler said that as part of the treatment patients were supposed to have visits home where they practised following their meal plan, but that this was difficult when based in a hospital hundreds of miles from home.
The college says being sent far away from home can have devastating, long-term consequences for patients’ mental health and jeopardise their recovery.
Its analysis, published on Monday, says that in the 2021/22 financial year, 71% of inappropriate out-of-area placements that ended over that time lasted for 15 or more nights, while 40% lasted for 31 or more nights. In March more than half of all inappropriate out-of-area placements saw patients travel more than 100km from home because a local bed was unavailable for the eighth month running, it found.
The college says that the coronavirus pandemic and cost of living crisis have put further strain on mental health services and that the elimination of inappropriate out-of-area placements “will require significant and sustained effort by the whole system”.
The Department of Health and Social Care said: “Everyone should have access to safe, appropriate mental health care and we recognise the impact that receiving care far away from loved ones can have.
“That’s why we are investing an extra £2.3bn per year to transform NHS mental health services by 2024, meaning more people will be able to receive care as close to home as possible.”
