Number of NHS beds for mental health patients slumps by 30%

This article was taken from: https://www.theguardian.com/society/2018/jul/21/nhs-beds-number-mental-health-patients-falls

By Toby Helm and Denis Campbell

Bed shortages in parts of England are so severe that patients are sometimes sent hundreds of miles from home

The number of hospital beds for people with acute mental health conditions, where a consultant psychiatrist is on hand to oversee treatment, has fallen by almost 30% since 2009 despite repeated claims by ministers that improving care for the mentally ill is now a top priority.

New official figures show that the number of beds for those with some of the most serious conditions – including psychosis, serious depression leading to suicidal feelings and eating disorders – has fallen from 26,448 in 2009 to 18,082 in the first quarter of this year.

Over the same nine years, the data also show significant falls in the number of mental health nurses working in the NHS – from 46,155 to 39,358 – and in the number of doctors in specialist psychiatry training, from 3,187 in 2009 to 2,588 in the first quarter of this year.

Last night, the MP Dr Dan Poulter, a former Tory health minister who is now practising part-time as an NHS doctor in mental health services, said it was clear that government rhetoric about giving mental health “parity of esteem” with physical health was not matched by action.

Poulter, who obtained the new data through parliamentary answers, said that mental health was still a “Cinderella service”, with child and adolescent mental health lagging the furthest behind acceptable standards. The service in which he works is not just inadequate but also unsafe for patients, he claimed. “The reality on the ground is that there are ever fewer beds available for the patients who need them. This means that people who are very unwell, for example with psychosis or depression with suicidal ideation, are unable to access timely inpatient care. Eating disorders is another service where there is often a long wait for patients who need beds for urgent inpatient care. This is not safe for the patients.

“Mental health professionals work incredibly hard but we are under-resourced. Despite the need to expand services to meet the needs of patients, and to provide more support for people with mental illness in the community, there are simply not the resources available to do it.”

Bed shortages are so severe in some parts of England that patients are sometimes sent hundreds of miles from home, and even to Scotland, to access inpatient care. Ministers have pledged to eradicate out-of-area care by 2020, but up to 700 people a month are still being cared for away from their home area.

Health organisations and charities said the data was further evidence that ministers were failing to respond adequately to a growing mental health crisis. Janet Davies, chief executive of the Royal College of Nursing, said that the figures showed that politicians’ promises to improve NHS provision for those experiencing mental illness had not been honoured.

“Despite all the rhetoric on the importance of mental health, these figures show the painful reality. Thousands of experienced professionals have been lost and this shortage of inpatient beds leaves the most vulnerable shunted around the country or even in prison cells waiting for the care they desperately need,” Davies said.

Paul Farmer, chief executive of the mental health charity Mind and chairman of NHS England’s taskforce on mental health in 2015-16, said: “Mental health services have often been seen as a soft target for cuts, and these figures are a stark reminder of the longterm consequences of under-investing in the mental health workforce.”

The 2012 Health and Social Care Act established that there should be “parity of esteem” between physical and mental health. But despite promises of extra funding, many mental health trusts have been forced to cut acute mental health beds. Many NHS staff complain that services in the community are so inadequately funded that they fail to prevent patients with serious problems from ending up in hospital.

In October 2017, the prime minister Theresa May stressed that improving the treatment of mental health was one of her top priorities. “Tackling the injustice of mental illness is one of my absolute priorities as prime minister and I believe that by taking these steps together we as a society can transform how we think about mental illness, and improve the way we care for all those with mental health problems,” she said. But since then, the number of acute mental health beds has continued to fall and is now at its lowest for more than a decade. Last week, in the House of Commons, she admitted that more needed to be done, and that the service had been “overlooked for too long”.

NHS England chief executive Simon Stevens last week identified mental health as one of the five priorities that the service’s ten-year plan will need to tackle. Due in November, this will set out how the NHS will spend the extra £20bn it has been given. He warned, however, that improving mental health provision could take more than five years to achieve – because of understaffing.

However, in his first speech as the new health and social care secretary on Friday, Matt Hancock did not cite mental health as one of his three main priorities, despite Theresa May’s strong personal interest in the issue and description of it as one of British society’s “burning injustices”.

A spokesperson for the Department of Health and Social Care said: “Mental health is one of this government’s top priorities and we are committed to seeing services improve through record amounts of funding, an additional £1bn between 2017-18 and 2020-2021, and major increases to the workforce, with 21,000 new posts to be created by 2021.” Government sources said that there was a recognition that more nurses were needed, which was why ministers had announced an increase of more than 5,000 extra nurse-training places, which would be available from September, including mental health training places.