Mental health patients treated far from home ‘less likely to recover’

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NHS watchdog expresses concern over wellbeing of thousands of patients and cost to NHS of ‘out of area’ care

Thousands of people with serious mental health problems are being locked up in treatment units far away from their homes, and left isolated and less likely to recover, the NHS’s care watchdog has warned.

The Care Quality Commission (CQC) is concerned that such patients’ chances of making a full recovery are being hit because they are denied regular contact with relatives and friends.

Of people with complex psychosis and other serious mental health conditions 63% end up being sent “out of area” for care because the local NHS does not have the beds, staff, or both to treat them.

Many people are being cared for sometimes more than 60 miles away from home, and for almost three years at a time, according to a CQC survey of care providers published on Thursday.

Mental health campaigners said the CQC report on the controversial practice, which ministers have pledged to scrap by 2021, should prompt the NHS to provide more beds closer to patients’ homes.

Paul Lelliott, the regulator’s deputy chief inspector of hospitals, said: “We are concerned about the high number of beds in mental health rehabilitation wards that are situated a long way from the patient’s home. This dislocation can mean that people can become isolated from their friends, from their families and from the services that will provide care once they have been discharged.”

The 600 to 700 patients a month sent out of area are also a concern because they spend twice as long there as they do in an NHS unit near their home, “which can increase their sense of institutionalisation, affect their onward recovery, and can be very costly”, Lelliott added.

Mental health rehabilitation services cost the NHS in England £535m a year, of which £356.6m is spent on out-of-area placements.

Private health firms receive 78% of the NHS patients sent out of area for care. The CQC found that they treat each NHS-funded patient for an average of 14.5 months compared with 7.5 months on an NHS ward. And patients they care for typically cost the NHS £162,000 per stay, compared with £81,000 in a unit run by the NHS itself.

“Tory ministers need to explain why there are so many private providers of rehabilitation units, why longer stays are costing twice as much as in the NHS, and come forward with plans to reduce the number of these placements,” said Barbara Keeley, the shadow minister for mental health and social care.

Rajesh Mohan, chair of the Royal College of Psychiatrists’ rehabilitation faculty, said: “The reason more and more patients are being sent inappropriately out of area is because NHS rehabilitation services have been closing at an alarming rate. In 2009 there were more than 130 such services in England; by 2015 that number had fallen by a third to just 82.”

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