A lack of beds at Lancashire’s mental health trust saw patients being sent as far away as Somerset, it can be revealed.
Psychiatric units across the country were so overwhelmed last year, 68 per cent of 220 ‘out-of-area placements’ were with private providers.
Sending patients out of Lancashire – including Bradford and Harrogate in Yorkshire – or to private firms cost the NHS £4m last year.
The figures have been described as ‘concerning’ by MPs, though Lancashire Care, which is responsible for mental health care across the county, said it has worked to reduce the number ‘significantly’.
Blackpool South MP Gordon Marsden said: “This is just further evidence of the inability of Lancashire Care to fulfil some of its basic functions, not just in Blackpool but across the county.
“The figures not only illustrate the shocking waste of public money as a result of all these transfers, but also the hardship and difficult for relatives and friends of people far away from their home.”
We should not have to send people to Somerset.
Blackpool North and Cleveleys MP Paul Maynard added: “I have seen numerous cases of people being sent far away from treatment for specialist care. I have long been concerned. When The Harbour opened we all had great hope it would meet the needs of local people.
“We should not have to send people to Somerset.”
A Lancashire Care spokesman said: “(An) investment of £3.8m has been made into developing enhanced community services to ensure people can be cared for as close to home as possible. This has seen out-of-area placements reduce to fewer than 20 – the number of adults in out-of-area beds on February 5 was 12 – and a 1.9 per cent reduction in admissions during 2017/18, despite a 9.8 per cent increase in demand.”
The 220 cases were recorded between December 1, 2016, and November 30 last year, with placements costing an average of £501 per patient per day.
Lancashire Care said any beds outside the county are classified as ‘out-of-area’, but said admissions to independent providers in Lancashire are also classed as such.
It said those sent to Somerset were a ‘very small proportion’ of older patients – and none were still there.
“The decision to admit someone to a bed so far from home is subject to careful consideration of all options and is only utilised in extenuating circumstances,” the spokesman added.
“In some cases, a person who requires very specialist treatment may be transferred out of the area to be cared for in a specialist bed, if the trust is not commissioned to provide it.”
Examples included specialist rehabilitation or eating disorder.
Lancashire Care has 338 beds, reserved for people with serious mental illnesses.
They include 154 at The Harbour in Preston New Road, Marton, and 164 medium security, low security, and step-down beds – for patients with needs somewhere between that of the general ward and intensive care unit – at Guild Lodge in Preston.
More beds are set to open in Chorley for men and women from September.
“Out-of-area placements occur when there is no bed available within the trust to admit a patient to,” the trust said.
‘Every effort’ is made to find one, it added.
“On January 4, 2016, the trust had 94 patients in private sector beds which highlighted the need to put in place a long-term sustainable solution to reduce the number of out-of-area placements,” the spokesman said.
“There were no older adults in out-of-area placements as of February 5. However, there are still significant delays to discharge due to a lack of onward provision in the care home sector, and this impacts on the trust’s ability to deal with the demand.”
The Gazette reported last month how hundreds of patients a week are unable to leave Lancashire hospitals – despite being medically fit and willing to do so – with many cases blamed on a lack of social care provision.
Fylde MP Mark Menzies said: “I’m pleased to see the number of out-of-area placements has significantly decreased according to the trust’s figures - and I would like that number to be zero.
“When someone is living with a mental health condition, it is vital they are treated as close to home as possible.
“Sending people as far away as Somerset is neither helpful to them and their families, nor cost effective. I hope the £3.8m invested by the trust means all patients can be treated close to home. The government has invested more money in mental health than ever before, an estimated £11.4bn this year, which will rise by a further £1bn by 2020. I hope the trusts are spending this record level of funding wisely.”
Last year, when statistics showed patients were being sent miles away from their homes for mental health treatment, NHS Digital said a national demand for beds was being reflected in Lancashire.
The government wants to stamp out inappropriate out-of-area placements in acute adult mental health services by 2020/21.
Where in Lancashire are the mental health beds?
Lancashire Care said it has 338 adult and older adult beds, made up of assessment wards, treatment wards, and psychiatric intensive care units. There are 142 at Burnley General and Royal Blackburn hospitals, 154 at The Harbour in Blackpool, 18 at The Orchard in Lancaster, and 24 at the Scarisbrick Unit at Ormskirk District General Hospital.
It is also ‘re-configuring sites in order to open beds in Chorley for males and females from September’, it said.
Chorley MP Lindsay Hoyle said that ‘re-configuration’ is the reopening of beds at Chorley Hospital, which he had campaigned to see brought back into use after they were closed by Lancashire Care. And it also has 164 specialist medium security beds, low security beds, and step-down beds at Guild Lodge in Preston, and 18 children and young people’s beds at The Cove in Heysham.
Why do patients get sent so far away?
When there are no beds to admit patients to, put simply. All requests go through a management centre called The Hub, Lancashire Care said, who prioritise patients based on their needs. An ‘inappropriate out-of-area placement’ is classed as any time a patient is admitted to a facility run by anyone other than their ‘home provider’, the trust said.
This can include other NHS organisations or private firms, even if they are within the Lancashire boundary.
“The trust aspires to care for people as close to home as possible and if someone has to be admitted to a bed outside the area/the trust, every effort is made to bring them back to a local bed as soon as possible,” a trust spokesman said.
Mum’s 220-mile round trip
Tara Palin called for better mental health services in Lancashire after her teen daughter was put in a specialist unit in Middlesbrough. The move left Mrs Palin with a 220-mile round trip on public transport, at a cost of £100 a time.
The Lancashire resident said at the time: “We get no help, no financial help, no emotional support. It’s just a ridiculous journey to have to make.”
Lindsay Hoyle, Mrs Palin’s MP, said he had ‘deep concerns about the provision of all mental health services in the local area’.
He said people being transferred far away was ‘unacceptable’. He added: “These transfers and the associated costs are a false economy, and cost the NHS even more than local services in the long run.
“Beds at Chorley Hospital have been closed under the guise of newer facilities becoming available at the Harbour in Blackpool, but I know from my own case work that there isn’t capacity there. It’s unfair on patients and hugely difficult for families to give support from such a distance.”
What do the figures show?
Published by NHS Digital, the figures show the north of England had more out-of-area placements at the end of November than any other region, with 215.
The midlands and east had 165, the south had 150, London had 90, and there were 15 cases classed as ‘unknown’.
Lancashire Care had 220 new placements from December 1, 2016 and the end of last November, of which 68 per cent were with private firms.
Some 48 per cent related to acute adult mental health care, nine per cent related to older adult mental health care, and 42 per cent related to psychiatric intensive care.
The average cost was £501 per day, and the total cost was £3,970,096.
Lancashire Care said it had 94 patients in private beds at the start of 2016, ‘which highlighted the need’ for a long-term solution.
A £3.8m investment in services has seen the number of out-of-area placements drop to below 20, with a ‘downward trajectory forecast’, the trust said.