Practice of sending mental health patients long distances for care has become endemic in NHS

The practice of sending mental health patients far away from friends and family to receive care has become endemic in the NHS, leading doctors warned as new figures show a rise in the number of patients sent miles away.

Some are even receiving care hundreds of miles away, the British Medical Association (BMA) said.

Ministers have pledged to eliminate “inappropriate out-of-area placements” for mental health patients by 2020/21, but new BMA figures show a rise in patients being sent out of area for treatment.

Medics said being sent far away for care can hamper care and recovery.

It means that patients can often be far away from their support network – with BMA chairman of council Dr Mark Porter describing how parents of a young man travelled for seven hours just to spend an hour with their son.

The union made Freedom of Information requests to health bodies in England to discover the number of mental health patients that has been sent out of area for care for the three years from 2014/15.

It found that the number of out-of-area placements increased from 4,213 adults in 2014/15 to 5,876 in 2016/17 – a rise of 39%.

The BMA found that the greatest distances patients had to travel to receive care were:

• Oxford Health NHS Foundation Trust sent a patient 532 miles to New Craigs Psychiatric Hospital, Inverness.
• The Trust also sent another patient 497 miles away to receive care at Royal Cornhill Hospital in Aberdeen.
• A patient was send 323 miles from Dorset Healthcare University NHS Foundation Trust to Priory Hospital Middleton St George in Darlington.
• And Leeds and York Partnership NHS Foundation Trust sent a patient 312 miles away to be cared for at the Glenbourne Unit in Plymouth.
• Figures provided to the union by Somerset Clinical Commissioning Group suggested that one patient was sent from Somerset to a care facility in the Highlands, 587 miles away. But Somerset Partnership NHS Foundation Trust contested the figures, saying that the CCG had provided incorrect information.

“The practice of sending patients with severe mental health problems to beds hundreds of miles away from their home and families has become endemic in the NHS,” said NHS consultant psychiatrist and mental health policy lead of the BMA’s consultants committee Dr Andrew Molodynski.

“The Government needs to get a handle on this situation because patients are being routinely failed by a system at breaking point, with tragic consequences.

“Being sent long distances for treatment has an impact on patients’ care and recovery.

“There have been tragic cases where coroners have ruled that the difficulties families have visiting a relative receiving care, as well as poor communication between hospitals in other regions and local mental health services contributed to deaths.”

BMA council chairman Dr Porter told delegates on Monday that Government ambitions to put mental health care on par with physical healthcare is a “very distant prospect”.

He said: “If your patient has mental rather than physical health needs, the situation is even worse.

“Thousands are shuttled around the country because of a chronic lack of beds. Isolated from their friends and family at their most vulnerable time.

“Some have to languish in police cells for their own safety, while their clinical staff scour the country for placements and transport.

“Their care suffers when communication breaks down between hospitals, and when they are so far from home. Like the young man whose parents had one day off a week to visit him, and spent seven hours on the road for one precious hour in his company.

“He suffered. Any of us would suffer in those circumstances.”

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

“We were the first country in the world to legislate for parity of esteem and we’re going to make sure it happens by reforming outdated mental health laws and with waiting time targets to improve standards of care.”

An NHS England spokesman added: “NHS England is investing an extra £400m in crisis resolution home treatment teams as part of our plans for the biggest expansion of mental health services in Europe.

“We’re also giving local mental health trusts new powers to tailor mental health services to better meet their area’s individual needs, improving local services and ending the practice of sending people long distances to receive treatment.”

Commenting on the findings, Samantha Nicklin, head of campaigns and public affairs at the charity Rethink Mental Illness, said: “These figures bring into sharp focus the continuing injustices people living with a mental illness are facing.

“Despite mental health attracting more attention as a political and social issue, it is clear that promises of increased funding are not creating change where it’s needed.”

Dr Ranga Rao from the Royal College of Psychiatrists, added: “Treating patients out of area can delay recovery so being sent away from their local area for care should only happen in exceptional circumstances.”

Shadow mental health minister Barbara Keeley said: “The Government promised to tackle the crisis in mental health services, but time and time again they have let patients and their families down and these figures show the situation continues to get worse.”

Mother’s anguish when late son was sent 150 miles away for mental health care

The mother of a patient who died by suicide after being sent 150 miles for mental health care has condemned the practice.

David Knight, who was being treated for paranoid schizophrenia when he died, received care at Cygnet Hospital in Weston-super-Mare – three and a half hours away from his home in Cornwall.

The 29-year-old died while staying with his parents on a long weekend at home.

Last year the coroner examining his death wrote to Health Secretary Jeremy Hunt and Simon Stevens, the chief executive of NHS England, urging them to avoid routine out of county placements in order to prevent future deaths.

Mr Knight’s mother Julie Nancarrow said she didn’t want anyone else to suffer as her family had.

She told the British Medical Association (BMA): “David needed his family around him, he didn’t like it on his own. He felt safe at home.

“They said there were not any beds in Cornwall – not one bed in Cornwall that they could have put him in.

“His dad could only get a day off a week so that was the day we would go and see him. But it was three and a half hours to get there and three and a half hours to get back and we would visit him for an hour. That would be eight hours.

“David was saying ‘can you stay longer?’ so I felt so sorry. I didn’t want to walk away and leave him. I said ‘we can’t David because we have that massive journey home’.

“He was so far away and I think he just felt he was on his own when he actually wanted his family close by him.”

She added: I don’t want anyone to go through what we’ve been through. It’s just so tragic.”

Coroner Dr Emma Carlyon wrote to NHS England calling for a review into the provision of acute mental health beds in the county. The coroner’s report noted “…the fact that Mr Knight was being treated out of county would have increased the risk of poor communication between the community treatment teams as the hospital would have been familiar with local service and it was very likely that this had a bearing on Mr Knight’s death”.

The BMA has warned that the number of out of area placements for mental health patients has increased by 39% since 2014/15.

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