Mental health trust reduces number of out-of-area placements - but 160 patients were sent to locations including Taunton, Southampton, and Darlington
- Credit: Archant
It is an injustice which has scarred countless mental health patients. Nicholas Carding reports on how a persistent lack of beds in the region takes ill people far from their homes and families.
Imagine being sent more than 200 miles away for heart attack treatment.
Or being told your broken leg can't be treated in Norfolk because of a lack of beds – and instead you'll be sent to Somerset for an operation.
For patients with physical health problems these scenarios are unheard of, yet these are the nightmarish realities for many mental health patients from Norfolk and Waveney.
Figures obtained by this newspaper through the Freedom of Information Act reveal that Norfolk and Suffolk NHS Foundation Trust (NSFT), which provides mental health treatment in the region, sent 160 patients out of the two counties for treatment in 2015/16 because there were no beds available.
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Some people were sent as far away as Taunton and Southampton.
Even young teenagers were taken away from their families.
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Thirteen-year-old NSFT patient Alicia Bradnum, who spent several weeks at units in Nottingham and Chelmsford after a suicide attempt, said she felt 'cut off' from her family and added 'no child should have to go through what I did'.
The figures indicate, based on the current reduction rate, the trust is still not on track to stamp out the practice of sending patients out of area for treatment by autumn next year – a key target outlined in a national mental health review earlier this year by Lord Crisp.
NSFT insisted it was working hard to treat all patients locally and said it had taken a number of steps - such as working with local services and holding a trust-wide review of its bed-stock. South Norfolk Clinical Commissioning Group, the lead commissioner for mental health in our region, said an extra 12 beds were commissioned in Central Norfolk last year to increase available beds locally and said bed-provision was 'a national issue'.
As we reported in January the number of NSFT patients sent out of Norfolk and Suffolk for treatment reached a record-high (279) in 2014/15. Between April 2015 and March 2016 (the most recent financial year) NSFT managed to reduce this number down to 160.
This was achieved after NSFT opened 12 beds on Thurne Ward at Hellesdon Hospital, with another three beds planned, and the introduction of a model which enables its community teams to increase support to a patient within hours if they appear to be heading into crisis.
The opening of private facility Mundesley Hospital in February has also helped keep patients in Norfolk, costing the trust £150,000 during the remainder of the 2015/16 financial year. In total NSFT spent £4.2m treating patients at inpatient units outside the trust. Former health minister Norman Lamb, the North Norfolk MP, welcomed the reduction in patients sent out of area,0 but said it should not happen at all.
'Patients treated out of area are at higher risk of committing suicide,' he said. 'I want to see this ended.'
Health bosses respond
In a statement the NSFT said it 'fully understands' the distress out-of-area placements can cause service-users and their families, particularly at a time when they are at their most vulnerable.
A spokesman said there had been an increase in demand for inpatient services, particularly in central Norfolk, which the trust worked to address in 2015.
'We focused on strengthening our community mental health services, as well as reviewing our central Norfolk Crisis Resolution Home Treatment (CRHT) service to ensure that patients could get the right care, more quickly,' the spokesman said.
'We have also introduced the Flexible Assertive Community Treatment (FACT) model across both Norfolk and Suffolk, which has enabled our community teams to increase support to a patient within hours if they appear to be heading into crisis.
'The approach has been to focus, wherever we can, on prevention rather than just cure, to keep people as well as possible, and to then keep beds free for those who are in essential need.
'If someone needs to receive the relevant care as an inpatient our aim is to have no patients being treated out of area.
'But if this is not possible as all of our beds are full, we will always seek a bed within area with other providers or in a neighbouring county, such as Cambridgeshire or Essex, before looking nationally. 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.'
A spokesman for South Norfolk CCG, the lead commissioner for mental health in Norfolk, said there were several issues that affected NSFT's ability to discharge patients from much-needed beds.
Issues such as limited accommodation options, welfare issues, strategic housing policy, and legal restrictions have impacted on mental health services and increased the delay in patients being discharged from units.
This in turn has left fewer beds available for new patients, according to the spokesman.
'The CCGs and NSFT continue to work very closely on all aspects of mental health care, including out-of-trust placements,' the spokesman added.
'Patients placed out-of-trust are regularly and adequately reviewed. Bed-space is an issue across the country.'
National calls made for end to practice
In February, House of Lords member Lord Crisp published the findings of an independent commission which found mental health patients were travelling 'unacceptably long distances' for treatment.
The much-anticipated review called for an end to the practice by October 2017.
Paul Farmer, chief executive of Mind, said it was 'a matter of urgency'.
'That some trusts have made significant progress in reducing the number of out of area placements shows what can be done when commissioners and clinicians decide that this practice is intolerable,' Mr Farmer said.
Meanwhile NHS England have confirmed a national review into specialist mental health services available for children and teenagers is being carried out, which could lead to more beds commissioned locally.
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