Patients with serious mental health issues being ‘warehoused’

An investigation has uncovered how NHS patients with serious mental health issues face being ‘warehoused’ on private mental health wards, often hundreds of miles from home.

The British medical Association blasted the widespread practice of patients being admitted to private wards, isolated from family members and with little to no contact with 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. These showed a £21 million increased spend on the private sector between 2016/17 and 2018 but an increase of just £2 million for NHS providers.

Private firms were also shown to have become highly dependent on NHS outsourcing in mental health services and have increased their take of the NHS rehab budget year-on-year (from 54 per cent in 2016/17 to 57 per cent in 2017/18) as the NHS continues to cut beds.

Andrew Molodynski, BMA lead for mental health, 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 seen in the cases of Whorlton Hall and Winterbourne, the ‘cut-off’ nature of these institutions can be a breeding ground for the development of harsh and abusive cultures. This has no place in modern mental healthcare.”

“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.”

Rebecca Cotton, director of Policy at the Mental Health Network, which is part of the NHS Confederation, said: “There has been much hard work across the sector to reduce the number of inappropriate out-of-area placements, but there is still a lot to do. There is still too much variation in the care available to people across many regions of the country, so we need to get these problems fixed.
 
“We must stress that not all out-of-area placements are unsuitable; we know that for many people they allow greater flexibility and choice as well as vital access to highly-specialised services that are simply not accessible locally to them.
 
“But many placements remain inappropriate and involve people being sent away from their support systems for long periods at the most difficult times of their lives. We must ensure local mental health services receive the investment promised if we are to see more people enabled to access the care and support they need closer to home.”

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