Record high for out-of-area beds

Record numbers of patients with serious mental health issues are enduring ‘damage and distress’ by being sent to out-of-area beds, according to new BMA analysis.

Despite health and social care secretary Jeremy Hunt pledging his personal commitment to ending such placements by 2020, 700 patients were found OOA (out-of-area) beds in January – 23 per cent more than the same month last year, and the highest since records began in 2016. 

Separate numbers from NHS England show beds for patients with mental ill health in the NHS were cut in the same period – the first three months of this year – by 200, as hundreds more opened in acute and general hospitals. 

A significant proportion (36 per cent) of patients in OOA beds were in them for prolonged periods of three months or more, according to analysis released to BMA News by NHS Digital.

The overwhelming majority of OOA placements were for want of a local bed. Of 610 patients in such beds at the end of November 2017, 220 were still in them in February, the last month for which figures were published.

BMA consultants committee mental health policy lead Andrew Molodynski said the analysis showed a deeply troubling picture of ‘sustained reliance’ on OOA placements as beds in the NHS were cut.

‘The fact that many placements continue for months on end is shocking and hugely damaging and distressing for individuals and their families,’ he said. ‘There does not appear to be a realistic plan from Government as to how this stain will be removed – no increase in beds, no meaningful increase in community crisis services.’

Senior doctors and managers were forced to spend ever more of their time managing an increasingly scarce resource, Dr Molodynski said. ‘Parity of esteem simply does not exist; we urgently need a clear plan as to how this is to be tackled as currently the situation is worsening.’

Mr Hunt told The Guardian last November he was ‘personally committed’ to ending OOA placements by 2020. ‘No patient should be sent away from their family and friends for treatment when they are seriously unwell,’ he said. 

The BMA raised concerns about OOA beds with NHS England last year after an investigation found rising use, harming patients and their families, and increasing costs to the health service.

They have been linked to more than 200 patient suicides by the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness.

Dr Molodynski called for an increase and protection of mental health funding, with a ‘ringfence’.

Labour shadow minister for mental health Paula Sherriff MP put the increase down to ‘eight years of unnecessary’ austerity. ‘Mr Hunt has pledged to end these placements yet this year they have risen to the worst levels on record – at the same time as a shortage of mental health beds,’ she said.

A spokesperson for NHS England said all areas of the country had ‘a clear, realistic plan’ for ending OOA placements by 2021 and ‘many areas’ already had.

This required ‘not simply opening more beds’ but increasing early intervention community services and investment, and a workforce boost, he added. The NHS was ‘making progress’ on such measures but none ‘can happen overnight’.

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