Despite promises to eliminate out-of-area placements, the NHS has spent an estimated £388 million on these placements since January 2024.
Hospital stays and out-of-area placements are increasing for people with mental health and behavioural needs.
Since the start of 2024, there were 7,191 new inappropriate out-of-area placements recorded in England, which equates to 113 placements every week. Within this number, 381 placements were for children.
Concerningly, the monthly number of out-of-area placements for children has continued to increase since October 2024. In March this year alone, 23 children were placed in a mental health service outside of their home network of services.
“Our new analysis underlines the growing pressure on NHS mental health services and the urgent need to rethink how we provide support for these people,” said Sarah Wakeling, chief executive at mental healthcare organisation Positive Support Group.
“The NHS has recently committed to opening new mental health A&Es. But just as important is addressing gaps in early intervention, specialist education, and community-based mental health care – so that we can help people before they need urgent care,” she continued.
Mental health crisis
The mental health crisis is too often talked about but little acted on. As Healthcare Today reported in May, the average time a person in a mental health crisis spent in A&E last year was an hour more than in 2023.
A report in early June from the Health Services Safety Investigations Body (HSSIB) has identified key risks across multiple areas that continue to affect the safety of mental health inpatient care. These areas include safety, investigation and learning culture, system integration and accountability, the physical health of patients in mental health inpatient settings, caring for people in the community, staffing and resourcing, digital support for safe and therapeutic care, suicide risk and safety assessment.
Despite national promises to eliminate inappropriate out-of-area placements, the NHS has spent an estimated £388 million on these placements since January 2024. These placements can often be many miles from home and can fail to provide the specialised, continuous care required to safely manage the individual’s needs.
The new analysis also shows that delayed discharge from a mental health setting is a growing issue for the NHS. There were a total of 636,597 bed days wasted due to delayed discharge since the start of 2024. Further analysis shows that the monthly number of delayed discharge bed days has been increasing from 33,264 in April last year to 50,916 in March this year.
The estimated cost to the NHS of these delayed discharge bed days is more than £254 million and without robust early support, the likelihood of crisis-driven hospital admissions will increase and once admitted, the absence of strong community-based care options can delay discharge, resulting in longer hospital stays.
“With the right preventative services, we can ensure that people are not staying in high-cost hospital settings any longer than they medically need to. Sustainable investment in community services is not just the right thing to do – it’s also better for families and better value for the public sector,” said Wakeling.
