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Mental health trust in top five for sending patients out of area for treatment

PUBLISHED: 15:00 27 June 2017 | UPDATED: 15:19 27 June 2017

Picture posed by model. Photo: Dominic Lipinski/PA Wire

Picture posed by model. Photo: Dominic Lipinski/PA Wire

PA

The region’s mental health trust has been listed in the top five in the country for sending patients out of the area for their care.

Figures uncovered by the British Medical Association (BMA) found nationally that the number of adults sent out of area in 2016/17 was 5,876 - up 40pc from 4,213 in 2014/15.

The findings also revealed that the amount spent on placing patients in out-of-area beds rose by 47 per cent from £108m in 2014/15 to £159m in 2016/17.

The BMA said patients sent away from home for treatment could expect an average round-trip drive of up to seven and a half hours to see friends and family. If relying on public transport, the average travel time to an ‘out of area’ placement could be as great as 13 hours.

But Norfolk and Suffolk Foundation Trust (NSFT) said reducing these numbers remained a priority to them,

The five trusts which sent the most adults out of area in 2016/17 were:

• Kent and Medway NHS and Social Care Partnership Trust – 586

• Barnet, Enfield and Haringey Mental Health NHS Trust – 410

• Manchester Mental Health and Social Care Trust – 372

• Norfolk and Suffolk NHS Foundation Trust – 359

• Oxleas NHS Foundation Trust – 316

MORE: More than £1.6m spent sending region’s mental health patients to private hospital in just seven months

In response to the findings, NHS consultant psychiatrist and mental health policy lead of the BMA’s consultants committee Dr Andrew Molodynski said: “The practice of sending patients with severe mental health problems to beds hundreds of miles away from their home and families has become endemic in the NHS. The government needs to get a handle on this situation because patients are being routinely failed by a system at breaking point, with tragic consequences.

“Being sent long distances for treatment has an impact on patients’ care and recovery. There have been tragic cases where coroners have ruled that the difficulties families have visiting a relative receiving care, as well as poor communication between hospitals in other regions and local mental health services contributed to deaths.”

MORE: NHS commissioners step in over Norfolk’s spending on sending mental health patients elsewhere

Dr Molodynski added: “When NHS beds are available patients can be admitted within hours but if there are no free beds in the local area doctors have to take time away from other severely ill patients to find a space, often resorting to private hospitals which, unlike their NHS counterparts, can refuse patients who have not been detained under section leaving doctors with ethical dilemmas. Patients then face long waits before being taken miles in locked ambulances to unfamiliar places.

“The huge distances often involved rules out regular visits from friends and relatives at a time in their lives when their support matters most.”

A spokesman for NSFT said: “Demand for mental health services, as with all NHS services, continues to increase year on year and it remains a priority for NSFT to reduce our OOA placements.

“One of our overarching aims is to prevent the need for people to require a crisis bed in the first place, so we are focusing on extending and improving services which help keep well for longer and therefore avoid their need for an inpatient stay, wherever we can.

“We do not want to send any patient who requires a bed out of area. We understand how distressing this can be for the person and for those close to them, especially at a vulnerable time.

MORE: Mental health trust boss admits ‘still too many’ patients were sent out of the area as more than £500,000 was spent on doing so last month

“However, if an individual is in crisis and an inpatient bed is the safest option for them - and on the given day local beds are full - it is in their best interest to receive a bed elsewhere, rather than remain at risk at home.

“If all of our beds are full, we will look to other providers within our local area, such as Mundesley Hospital, in North Norfolk, or in a neighbouring county before looking further afield.

“Our trust has recently commissioned an independent review of its acute care pathway and associated community services with a focus on the number of beds required for day-to-day services. The review has been undertaken in conjunction with Norfolk and Waveney and Suffolk CCGs.

“This review concluded that there is a range of clinical variance across Norfolk and Suffolk in service models, in referral and admission rates and in the operation of community teams. There are clear opportunities to spread learning and practice across the Trust to improve the overall service efficiency and effectiveness.

MORE: Bed shortage means dozens of mental health patients are still being sent miles from Norfolk and Suffolk for treatment - three years after pledge

“The report concludes that if clinical variance is addressed, and additional alternatives to hospital admission are introduced, the current number of NSFT beds could be sufficient to continue meeting demand.

“The design of a non-medical crisis café service model is underway to support people experiencing heightened emotional distress and on an escalation path to crisis. It will focus on de-escalating the individual’s immediate need, offering appropriate interventions, ensuring the individual has a short-term support plan and engage the individual with appropriate community resources.

“A project is also underway to design a community personality disorder service led by a trust consultant.

“Over the past two years, we have also focused on strengthening our community mental health services, as well as reviewing our central Norfolk Crisis Resolution Home Treatment (CRHT) service as this area sees the majority of OOA.

“We have also introduced the Flexible Assertive Community Treatment (FACT) model which has enabled our community teams to increase support to a patient within hours, if they appear to be heading into crisis.”

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