No end in sight: Over 5,000 cases of patients with mental illness being sent more than 100km away for vital treatment

Press release
21 June 2023

Thousands of adults with acute mental health needs and requiring inpatient care, have been sent hundreds of miles from home, for their hospital treatment due to a lack of beds and specialist care.

Despite it being two years since Government’s own deadline to end this harmful practice (March 2021), there have been almost 9,000 (8,925) new inappropriate ‘out of area placements’ (OAP), at a cost of £217.5 million to the NHS.

The Royal College of Psychiatrists’ analysis of NHS data shows that an average of 12 new OAPs started every single day from April 2021 to March 2023. In the same period, over half 5,335 (56%) of all placements resulted in patients being sent more than 100km away for vital treatment.

These placements, which can stretch for months on end, continue to cause significant harm to patients, according to the Royal College of Psychiatrists and the British Medical Association.

Together, they have written to the Mental Health Minister, Maria Caulfield MP, to demand an end to inappropriate out-of-area placements. They are calling for urgent investment in mental health services, especially in the community so that more patients receive effective help close to home before reaching crisis point.

More specialists are also needed across psychiatric disciplines, from child and adolescent psychiatry to intellectual disability psychiatry, so that patients do not have to go out of area for this specialist care.

Fifteen-year-old Eve Reynolds (not her real name), was sent 145km from her home in Cheltenham to a hospital in Maidenhead. In the first three weeks, her family clocked up almost 3,000km driving back and forth, as they are forced to make six-and-a-half-hour round trip journeys, for visits that are limited to two hours.

Speaking to the BMA’s The Doctor Magazine, Eve’s dad, Joe Reynolds said:

“We were heartbroken as parents, to see our daughter have to go so far away from home. We were told we were lucky to get a bed at all. It was getting to a point where it was very serious and we just want her to be safe. I could’ve said “no”, but the next one available might have been even further away. If she has a bad day, it’s not like you can just jump in the car. It has to be a planned journey, you have to make sure other children are picked up from school.”

Dr Adrian James, President of the Royal College of Psychiatrists, said:

"First and foremost, we need comprehensive community services to avoid admission wherever possible. We also need beds available locally when patients need admission. This is severely lacking in many areas.

“This unacceptable practice - sending patients hundreds of kilometres away from their homes and families - has likely been happening for decades. It risks patients’ mental health to such a degree that they often remain in hospital for longer.

“Government must keep its promise to put a stop to this practice. Patients should be offered effective alternatives to hospital admission so they can receive help earlier, from the right specialist, for their specific needs, instead of being sent out of area for treatment.

“When patients require hospitalisation, it is vital that there are properly staffed inpatient wards, which depend on a robust mental health workforce. This is impossible without the long-awaited NHS Workforce Plan, which must be published urgently.

“If these placements continue it is ultimately patients who will pay the price.”

BMA mental health policy lead Dr Andrew Molodynski, said:

“It is shameful that mental health patients in this country are being routinely let down by this Government who are now two years past their target of ending the practice of sending patients out of area for treatment by March 2021 and still failing miserably.

“Sending incredibly vulnerable patients with acute mental health needs hundreds of miles away from home, from family, and from loved ones has a hugely detrimental impact on their ability to recover effectively and places them at increased risk. This isolating and dehumanising practice is a direct consequence of a fragmented and underfunded mental health care system that has been letting patients down for far too long.

“It is absolutely crucial that the Government prioritises the expansion of inpatient mental health beds in England alongside the expansion of the mental health workforce, so this harmful practice is abolished once and for all.”

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