Rise In Numbers Sent Miles For Treatment

For issues specific to caring for someone with mental ill health.
As many readers will already know , this problem is increasing despite Government reassurances :


http://www.independent.co.uk/news/healt ... 19411.html


Rise in mental health patients sent hundreds of miles from home for treatment 'hugely concerning', experts say.

Exclusive: NHS spends £83m treating people out of area.


Mental health groups have said a significant increase in the number of mental health patients being treated miles away from home is “hugely concerning”.

Patients who have spent birthdays and Christmas a five-hour drive from their loved ones told The Independent that it made the already “scary process” of being admitted even harder.

They added it was also a “totally counterproductive” use of NHS funds as private facilities are generally the only place with spare capacity.

In April 2016 the Government said that by 2020 it would eliminate inappropriate out-of-area placements (OAPs) where patients can’t be seen locally.

But analysis by The Independent of the first 12 months of NHS reported data shows that it has become more reliant on the practice.

It shows that at the end of October 2017, 710 patients were being treated away from their local trust compared to 504 patients back in November 2017 – the first full month of reporting.

But the number of inappropriate placements rose as high as 885 patients in August this year.


In total the NHS in England had 7,615 inappropriate OAPs in the 12 months to October, a significant jump on the 5,876 identified by analysis from the British Medical Association in 2016/17, before reporting began.

This amounted to a total of 215,595 days, sometimes spent away from friends and family, and at a total cost to the NHS of £83m.

While some OAPs occur because patient needs a specialist service, 95 per cent result from a lack of beds locally rather than it being the best treatment option.

Mental health groups warned this can have a negative impact on patients’ recovery and “places an enormous burden” on their carers.

This is the experience of 27-year old Laura Nuttall, who has twice been sent more than a hundred miles away for care.

“The first time was around two years ago, I live in Lincolnshire and I was hospitalised into an NHS funded bed, in a private hospital in Manchester,” she said.

“But when I was 16 I had to go down to Kent and had to stay there for seven months, I spent my birthday and Christmas there.

“Having family nearby is a really important thing, at the time we were really fortunate that it was possible to be admitted – I needed it to stay alive.

“But being admitted is such a scary process, knowing that your family can’t just come and visit when they want makes that harder.”

While the Government has recently announced plans for mental health support in schools, and a four-week wait target for under 18s, the realities of funding put that at risk.

Earlier this year Labour accused the Government of “empty promises” after NHS Clinical Commissioning Groups figures showed half the groups in England expect to spend proportionately less on mental health.

The October figures show there were also more patients sent more than 100km (62 miles) away; 385 compared to 204 November last year.

Forty patients in October were sent nearly 200 miles away, and more placements lasted more than a month – 140 patients, up from 13 last year.

Laura, who has a condition known as schizo-affective disorder, said when she was hospitalised in Kent she needed one-to-one supervision, 24 hours a day, with a nurse or staff member sitting with her while she slept.

Alongside her medication this could only happen in a mental health facility, but it also means patients are cut off from their family.

Over Christmas she did spend a few hours with her dad, but this was only possible because he could make the five-hour journey.

“Christmas for him was ten hours driving, it’s not ideal,” she told The Independent.

Other patients, from as far away as Ireland, didn’t have anyone who could drive to visit them.


Laura is now training as a mental health nurse, and has a YouTube channel where she talks about her experiences, as well as highlighting the help she’s had from mental health staff.

She told The Independent that as nurses they are taught the importance of involving families and carers in the decision making and treatment of mental health.

Last month NHS trusts were issued with new national standards to cut out of area placements, these will also place more emphasis on community based care and mental health crisis teams.

Sophie Corlett, director of external relations at the mental health charity Mind, said: “With the Government and NHS committing to putting an end to out of area care by 2021 as part of their five-year plan for improving mental health services, it’s hugely concerning to see the number of people being treated out of area going up and not down.”

This was echoed by Dr Ranga Rao, the Royal College of Psychiatrists’ national lead for acute in-patient care, who said: “On the face of it, these figures are worrying.

“Patients should only be sent away from their local area for care if it is in their best interests or in exceptional circumstances, otherwise it can have a negative impact on their recovery and place enormous burden on carers.”


A Department of Health spokesperson said: “It is completely unacceptable for patients to be sent away from their family and friends for treatment – that is exactly why we’ve committed to end inappropriate placements by 2020.

“We have legislated to put mental and physical health on an equal footing and we’re going to make sure it happens by reforming outdated mental health laws and introducing waiting time targets to improve standards of care.”


Needless to add , one has to have the means in order to travel , and stay overnight on occasions when visiting.

A recent posting has highlighted this problem.

In some cases , treatment without the comfort of a family member around seems counter productive.
Hm, this seems odd. Either some geographical areas have hugely MORE beds than others or else everyone needs to be 'swapped around' BACK to nearer home. If some areas have MORE beds than other areas, then WHY?

Also, clearly some patients may need to be in areas 'distant' if the facilities for treatment are better elsewhere (eg, if there are particular psychiatric specialisms at some hospitals but not others).

And then, again, some patients may not 'need' to be near home - eg, ones that may be 'so bad' that they don't know where they are anyway, and don't care, and maybe also have family that wouldn't visit anyway! Or they don't HAVE family.

It all sounds a 'hodgepodge' .....as usual. Firefighting and short notice.
Not a good start this morning ?

https://www.theguardian.com/society/201 ... eremy-hunt

Mental health patients still sent hundreds of miles for treatment.

Despite government promises to end practice, figures show almost no change since 2016.


Hundreds of mental health patients are being sent hundreds of miles from home to get treatment, despite ministers branding the practice damaging and unacceptable.

Latest NHS figures show that in February 650 adults in England had to travel for inpatient treatment, even though Jeremy Hunt, the health and social care secretary, has pledged to reduce, and eventually ban, out-of-area placements by 2020.

That figure was just 50 fewer than in January and those 700 constituted the highest number since hospitals began keeping records in late 2016. It was partly explained by 55 NHS trusts supplying data to NHS Digital compared to 52 in February.


The fact that so many out-of-area placements continue has prompted concern for the patients and families involved and sparked fears that the planned abolition of the practice by 2020 may not be achieved.

“Doctors, nurses and social workers often spend many hours hunting for out-of-area beds, taking them away from other severely ill patients,” said Dr Andrew Molodynski, the mental health policy lead for the British Medical Association, which unearthed the figures. “The huge distances often involved rule out regular visits from friends and relatives, at a time when their support matters most.”

The health service regulator, NHS Improvement, has criticised the practice as “bad for patients”, because they can end up isolated and less likely to recover, and also expensive for the NHS. Patients have gone from Dorset to County Durham and one even from Oxford to Inverness in Scotland.

Hunt made clear last year that “no patient should be sent away from their family and friends for treatment when they are seriously unwell. It shouldn’t happen for physical health and we shouldn’t accept it for mental health,” adding that he is “personally committed to ending the practice by 2020”.

However, since this pledge, the number of mental health beds in England has fallen. There were 18,082 mental health beds available in January, February and March, 200 fewer than the 18,282 that existed in October, November and December 2017, other NHS Digital data shows.


Molodynski also highlighted that around a third of patients in out-of-area units spend at least three months there. In all, 220 of the 610 placements still ongoing on 30 November last year had lasted at least 90 days. “The fact that many placements continue for months is shocking and hugely damaging and distressing for individuals and their families,” he said.

NHS Providers, representing English trusts, also voiced unease at the growing numbers of patients being sent at least 100km from home. In February 2017 that happened to 217 patients, 40% of the placements that month. This February that had risen to 355 patients, 55% of placements.

Saffron Cordery, its deputy chief executive, said it was “particularly worrying” that the proportion of patients displaced for at least 31 days rose from one in seven (14%) in February 2017 to one in five (22%) a year later. “No mental health trust wants to do this. We know people recover best when treated in their communities, close to family, friends and carers.”

“It’s right that ending out of area placements has been made a priority, but it won’t happen without the right resources in the right places.”

NHS England has ordered trusts to disclose how many patients they send out of area, and how long for, in a bid to understand the scale of the practice, which doctors say involves patients being “shuttled around the country”.

More positively, the most recent data show that what NHS England deem “inappropriate” out of area placements have been cut and that the number of bed days involved in those placements has also fallen.

NHS England said that out of area care no longer happened in some parts of the country and there are plans to end it altogether by 2021.

A spokesman said: “Getting people the care they need, when they need it, close to home requires not simply opening more beds but substantially increasing early intervention community services, which offer a genuine alternative to hospital admission underpinned by a clear plan, additional investment and a boost to our workforce, all of which the NHS is making progress on but none of which can happen overnight.”


Smoke and mirrors again ... promise one thing , deliver another.

What does carer do in these situations ?

Travel at great expense to visit his / her caree ?

Simply do nothing and allow the System to function ?

Carer / Caree ... a partnership.

What are the " Rights " of the carer in these unacceptable situations.

" John's Campaign " ... extend across to mental health ???????

https://www.carersuk.org/forum/specific ... ense-33433

If not , discrimination through type of illness ?????