Hundreds of mental health patients are being ‘warehoused’ in privately-run premises hundreds of miles from home, a BMA investigation has revealed.
The investigation uncovered a widespread practice where NHS patients with serious mental health issues are admitted to private wards, isolated from family members, and have little to no contact with the NHS doctors overseeing their treatment.
Research by the BMA’s Doctor magazine found that NHS mental health rehabilitation wards have all but disappeared from 18 Clinical Commissioning Groups and NHS trusts in England, leaving five million people in those areas reliant entirely on out-of-area private sector provision.
This is a costly option and of the 176 CCGs which responded, only 78 could provide spending figures for the past three years.
Those figures showed a £21m increased spend on the private sector between 2016/17 and 2018, but an increase of just £2m for NHS providers.
Mental health rehabilitation, which provides intensive support for severely ill patients to help get their lives back on track, costs the NHS £535m a year. Stays last months or years before people are settled back home and are known to last twice as long in the private sector as in the NHS.
Private firms were also shown to have become highly dependent on NHS outsourcing in mental health services, increasing their take of the NHS rehab budget year-on-year (from 54% in 2016/17 to 57% in 2017/18) as the NHS continues to cut beds.
The research found that while many trusts and CCGs are spending most of their budget on private providers of this type of care, some are spending all of their budget. Over the last three years these include:
- NHS Sandwell and West Birmingham CCG at a cost of £20.26m
- NHS Walsall CCG at a cost of £12.5m
- NHS East Lancashire CCG at a cost of £12.44m
- NHS Blackburn with Darwen CCG at a cost of £11.08m
- NHS Greater Preston CCG at a cost of £10.26m.
Commenting on the findings, the BMA lead for mental health, psychiatrist Dr Andrew Molodynski, said: “This practice goes against the very nature of rehabilitation which should be a transitional process, helping to reintegrate a patient back into society.
“As well as the debilitating impact on the patient, the eye-watering sums being spent on out-of-area private providers is a clear sign that the Government must get a grip on this worrying practice. There are no positives here for patients, families, care services, or the public purse; quite the opposite. We need to ensure that care is available closer to home to give patients the best possible chance of recovery and reintegration.”
The Royal College of Psychiatrists said that the data showed that the NHS was failing high numbers of vulnerable patients in need of rehabilitation. Dr Raj Mohan, Chair of the Rehabilitation and Social Psychiatry Faculty, Royal College of Psychiatrists said:
“The data is extremely concerning. The high numbers of people with longer term serious mental illness being sent out-of-area for treatment shows that we are failing those who need rehabilitation care.
“There is a huge human and financial cost to sending someone out-of-area. Each out-of-area placement is a vulnerable person sent away from their family, friends, and the places they know, and makes it harder for them to access the services they need when they are ready to live in the community again.
“Our #InSightInMind campaign is calling for an end to out of area placements, and investment in the local rehabilitation services that people with severe mental illness need.”
Paul Farmer, Chief Executive of Mind, said: “The lack of NHS rehabilitation services in some areas is further evidence of the need for significant investment to improve the state of the buildings where people receive care – so that wards provide safe, therapeutic environments for people.
“The NHS has rightly committed to improve mental health services and this must include ensuring that people can get the treatment they need, when they need it, and close to home.”