Mental health trust boss admits 'still too many' patients were sent out of the area as more than £500,000 was spent on doing so last month
PUBLISHED: 19:01 30 March 2017 | UPDATED: 19:45 30 March 2017
More than £500,000 was spent on sending patients under the care of the region's mental health trust to other facilities in the last month as bosses admit "still too many" patients were being sent out of the area for treatment.
Norfolk and Suffolk NHS Foundation Trust (NSFT) has seen a large rise in the number of ‘bed days’ spent by patients either outside the two counties, or at private providers, since April 2016.
And £571,000 was spent on sending patients out of area or to other facilities last month, £480,000 more than budgeted.
But the trust’s director of operations Debbie White insisted the trusts was “not complacent” and “fully understands the impact” on patients.”
In April 2016, 26 days were spent by NSFT patients at hospitals outside Norfolk and Suffolk, but in February this year the number rose to 470. This was in addition to 302 days spent at the private Mundesley Hospital in April 2016, compared to 514 in February 2017.
The figures come as the trust remains under pressure to stop sending mental health patients out of the area for treatment, sometimes hundreds of miles from their families.
In 2014 the NSFT and health commissioners set themselves a four month deadline to ensure they had enough beds in the region.
But three years later the problem remains, while a review into the number of beds available at the trust is due to be released in April or May.
So far since April 2016, £3.8m has been spent by the trust on the out of trust bed days - more than £2.9m more than budgeted.
As of yesterday, there were 15 NSFT patients receiving medical care outside Norfolk, while nine were being treated at the Mundesley Hospital - despite the hospital remaining in special measures and being rated ‘inadequate’ for safety just this month.
No Suffolk patients were receiving out of area care, or care from private providers.
Debbie White, NSFT Director of Operations, said: “Our staff have worked incredibly hard over the past two years to keep local patients in local beds, as much as possible.
“However, as has been seen in other NHS trusts nationally, demand for inpatient beds and, in fact, all mental health services, has steadily increased over the past five years. And yet funding to support mental health services has not always followed at the same rate, as for other areas of healthcare.
“We do not want to send any patient who requires a bed out of area. We understand how distressing this can be for the person and for those close to them, especially at a vulnerable time.
“We are not complacent and we continue to look at ways to avoid, wherever possible, any out of area/out of trust placements.”
Ms White said year-on-year, things had improved - with 144 patients sent out of area between April 2015 and the end of January 2016. This was compared to 95 patients between April 2016 to the end of January this year.
“It’s still too many and we fully understand the impact on those 95 people,” she said. “But improvement has been seen. No trust wants to send a patient out of area for their care and this remains a top priority for our trust.”
But she said if an individual was in crisis and an inpatient bed is the safest option for them - and on the given day local beds are full - it was in their best interests to receive a bed elsewhere, rather than remain at risk at home.
She added: “It is a fact that pressures on local beds remains high, as we see in all areas of NHS care, and demand for our beds continues to increase, year on year. Last year, we saw 22,000 more patients than we did in 2012-13.
“The pressure on beds can also be as a result of a reduction in care support. We are seeing an increasing number of frail elderly people whose care support can no longer be provided within their own home.
“Added to that, we have seasonal pressures on beds which affect mental health services in the same way as they do other areas of NHS care and social care. In the winter months we all see an increase in admissions.
“To manage all of this we have reopened a crisis assessment ward, and further increased bed numbers in that ward within the past few months. We have teams of staff ready to respond to patients in crisis in our community services to try and keep them as well as possible, and we use beds from other providers in our own counties when we can.
“However, patients will always be offered an inpatient bed if that is what they need, and if all of our local beds are full then we will do everything to keep our patients safe and get them a bed as close to Norfolk as possible. When a patient does need to go to a bed further afield we do everything we can to return them as close to home as soon as possible.”
IT and phone failure
A meeting of the NSFT Board of Directors this afternoon heard how IT and phone systems across the trust’s Norfolk locations were out of action for a number of hours on Friday.
Director of Strategy and Resources Leigh Howlett told the board scheduled maintenance had taken place before the fault. She said engineers had tried to bring the system back online, but were not able to for some time. She added Suffolk had not been affected.
A spokesman from Campaign to Save Mental Health Services in Norfolk and Suffolk said GPs had not been able to make referrals and staff could not look up notes.
But Ms Howlett said lessons had been learned, and calls had been diverted to mobile phones.
“They instigated business continuity plans, and although this was not something we wanted there were no clinical incidents or patient safety issues reported,” she said.
New auditors brought in
At the board meeting it was also revealed auditors Mazars were helping NSFT collate mortality data.
Medical director Bohdan Solomka said the auditors - who examined unexpected deaths at Southern Health NHS Foundation Trust in 2015 - were looking at why deaths occur in certain areas.
For example, he said many service users in West Norfolk were elderly and may have dementia. Therefore their deaths may be due to poor physical health.
But work carried out by Mazars would be able to shine a light on why certain deaths were happening. He said working with Mazars was different to an independent review carried out by experts Verita last year into whether the trust had a high levels of unexpected deaths. Verita found the number of unexpected deaths at the trust were not above average.
“It is not about league tables, which make people defensive,” he said. “The idea is to make sure we learn from every death.”
Waiting times increase for young patients
Waiting times for children and young people seen by the trust increased by 3.2pc in January, but NSFT still hit the target of seeing 80pc of CAMHS patients within the standard times set.
In Norfolk, service users under 18 should be seen within eight weeks, in Suffolk it is 15 weeks.
Some 94.3pc service users were seen in the standard time, but some young people were assessed by the YMCA, rather than NSFT, or private providers.
Andy Goff, Locality Manager for Children, Families and Young People’s Services for the trust, said using third parties was available after NHS England provided extra funding in 2016 to reduce waiting times for therapy for young people in central and west Norfolk.
He said: “To enable young people to be able to access qualified therapists in a timely way this was considered to be the most effective use of resources and to of real benefit of our service users.”