Scores of mental health patients in Lincolnshire were inappropriately
sent miles away for treatment last year because of a lack of beds.
The latest figures from the NHS have revealed that around 260 mental
health patients with acute needs in our county were subject to
“out-of-area” placements in 2018.
It means they were sent to a unit outside the catchment area of their
mental health service in order to receive the inpatient treatment they
needed.


Some examples of when these placements would be considered appropriate
would be if the patient became unwell when they are away from home, or
if there were safeguarding reasons such as gang-related issues,
violence and domestic abuse.
However, 250 of the cases seen in Lincolnshire were due to a lack of
beds - deemed an “inappropriate” out-of-area placement by the NHS.
Experts warn that “traumatic” out of area placements can worsen
people’s chances of recovery, and say more invested is needed to
ensure people get the help they need.
Mark Winstanley, CEO of Rethink Mental Illness said: “We have got to
stop sending people miles away from home when they’re experiencing
great distress.
“Anyone who has spent even a night in hospital knows how important it
is to stay close to home, so it’s disappointing to see these numbers
sliding in the wrong direction.
“It is up to local commissioners to deliver on NHS and government
commitments to ensure that those of us who are most severely affected
by mental illness are able to access help including local
rehabilitation services.”


Some 20 of the out-of-area placements were more than 200km (124 miles) away from
their mental health service - farther than the distance between
Lincoln and London as the crow flies.
A further 165 placements were more than 100km (62 miles) away, which is greater
than the distance between Lincoln and Manchester.
Of the placements that had finished over the course of the year, 95
had gone on for more than a month - and 10 of them for more than 90
days.
The placements cost health chiefs in Lincolnshire around £500 a day to
place an acute mental health patient in a bed outside their local
network.
That worked out as a bill of more than £4m over the course of the year.
An NHS England spokesperson said: “The NHS is committed to eliminating
inappropriate out of area placements so that patients get the right
care, at the right time and as close to home as possible.
“The NHS Long Term Plan will also increase early intervention
community services and strengthen 24/7 crisis response and home
treatment teams - meaning more people will get care at home, offering
a genuine alternative to hospital admission.”


The government has recognised that patients should be treated in a
location that helps them to retain the contact they want to maintain
with family, carers and friends, and to feel as familiar as possible
with the local environment.
In 2016, the government set a national ambition to eliminate
inappropriate out of area placements by 2020 to 2021.
However, if anything it looks like the situation is getting worse.
Nationally, there were 8,125 inappropriate out-of-area placements
started across England in 2018 - up from 8,035 in 2017, which was the
first time these figures were published.
The figure in Lincolnshire has risen sharply from 175 to 250 over the
same period.
Vicki Nash, head of policy and campaigns at national mental health
charity Mind, said: “We are nearing the NHS’s own target of zero out
of area placements by 2020/21, but the figures are going in the
opposite direction.
“There is a huge amount of work still to do to get the numbers down.
“Too many people with mental health problems are being forced to
travel hundreds of kilometres from their friends and family to receive
the treatment they need.
“This can worsen people’s chances of recovery, as well as being
expensive for the NHS and the taxpayer.
“We urgently need to see investment in mental health services reaching
the frontline, so that people can get the treatment they need, when
they need it, close to home.
“The NHS has rightly made ambitious commitments for improving mental
health care.
“But while we are waiting for these to be delivered, thousands of
people continue to face the traumatic experience of being sent away
from home and separated from their support network to get the help
they need.
“This is a crucial year and the urgency of the NHS delivering on its
promises cannot be overstated. It must do far better for the people
with mental health problems in its care right now.”

Andrew Rix, Chief Operating Officer at South Lincolnshire Clinical Commissioning Group, said: “In Lincolnshire, we have a strong partnership between commissioners and mental health services to provide care as locally as possible.

"Despite having the lowest number of mental health beds per head of population in the country, we have made excellent progress.”

Jane Marshall, Director of Strategy at Lincolnshire Partnership NHS Foundation Trust, said: “Our achievements include the opening of the county’s first psychiatric intensive care unit, a psychiatric clinical decisions unit and we have expanded home support for people in a mental health crisis.

"All of these services help reduce demand on inpatient wards and have helped to halve the average length of stay for patients.

"And we are continuing to work with our partners to further improve our services for Lincolnshire residents.”