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This project aims to reduce the use of
unnecessary 'out of area treatments' (i.e. long-term hospital
placements or residential and nursing homes) for people with
complex mental health needs.
Disinvestment in NHS Rehabilitation Services
however has led to a rapid and uncontrolled rise in independent
sector provision in so called 'out of area treatments' (OATs).
The result of this rise has meant that many
people with complex mental health problems (mostly with a diagnosis
of schizophrenia) are currently being displaced from their
communities by being placed in OATs.
The people who are placed in out of area
treatments usually do not have different needs to those people who
are placed locally; out of area treatments therefore take people
away from their families and communities for no good reason.
Studies have demonstrated that moving people
to back into the care of local services and helping people live as
independently as possible is likely to be good for the individual
as well as saving money which could be used in more useful
ways.
Recent activities have included:
National Mental Health Development
Unit QIPP workstream on out of area treatments
- Through membership of the National Mental Health Development
Unit workstream on out of area treatments, the College
has contributed to the development of In sight, in
mind: a toolkit to reduce the use of out of area services
(which will be launched in the Spring of 2011), a toolkit for
health, social care and housing commissioners which seeks to assist
in developing and commissioning services that are as close to home
as possible for people using mental health services and their
families.
A research project on the role of
professionals involved in the reviewing of OATs
- PCTs who indicated – via response to a freedom of information
request submitted by the policy unit – that they employ someone in
a dedicated role to review OATs were sent an online questionnaire
(directly to the people in these roles) to find out details about
how they operate, what successes they have had, what difficulties
they face, what qualities and aptitudes are required to undertake
this kind of work successfully, what kind of background they have
(managerial/clinical). Results from this survey will enable the
policy unit to build up a picture of this role, which has been
identified as a cost-effective and patient-centred approach to
better managing OATs. The findings from this study will be included
as a downloadable resource in the toolkit mentioned above (In
sight, in mind).
Making the case for a rehabilitation
facility: helping psychiatrists and commissioners to work
together
Freedom of information request to PCTs
and local authorities on OATs expenditure
- In 2009, the policy unit surveyed all PCTs and local
authorities in England to find out answers to the following
questions:
- What was your total expenditure
in the financial year 2008-9 on residential and nursing care
placements for people with mental health problems?
- What proportion of the total cost
was spent on placements within and on placements outside your local
PCT/LA area?
- How many individual clients does
this figure represent?
- How many of these individuals
were in placements within and how many were outside your local
PCT/LA area?
·
The survey, which had a response rate of over
75%, shows that OATs are 65% more expensive (£34,000 versus
£21,000) than in-borough placements, and that 22% of all people in
placements are in OATs. These findings informed
a paper in
The Psychiatrist and also
an article in The Guardian.
·
In January 2010, all PCTs and local
authorities in England were sent an individualised breakdown of the
results of the survey (showing data nationally and also for their
own PCT or local authority), along with a copy of Enabling recovery
for people with complex mental health needs: A template for
rehabilitation services, (ADD LINK HERE) a document published
recently by the Royal College of Psychiatrists' Faculty of
Rehabilitation and Social Psychiatry.
In January, all PCTs and local authorities in England were sent
an individualised breakdown of the results of the survey (showing
data nationally and also for their own PCT or local authority),
along with a copy of Enabling
recovery for people with complex mental health needs: A template
for rehabilitation services, a document published recently by
the Royal College of Psychiatrists' Faculty of Rehabiliation
and Social Psychiatry.
For more information
regarding this project, please contact Masood Khan
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