Mental health patients ‘should not have to travel across England for beds’

Independent commission lists ways psychiatric services must improve, and notes funding lag behind physical health

Mental Health fundingLack of funding for some mental health services in England is putting vulnerable people, including children, at risk, the report says. Photograph: Alamy


About 500 patients a month are having to travel more than 31 miles (50km) for acute care in psychiatric wards, according to an independent commission headed by former NHS chief executive Nigel Crisp and supported by the Royal College of Psychiatrists. Others face difficulties in accessing alternative care in the community, says the commission’s report.

It proposed to end the practice in which some patients are treated miles from their homes and families by October next year, as this was“potentially dangerous”.

Other proposals included a pledge from government that patients face a maximum four-hour wait for admission to an acute ward or for home-based treatment, fewer delayed discharges from hospitals and more housing to help those in short-term crisis or needing longer-term care.

There had to be more investment in home-based treatment, and a greater role for patients and carers in the services they used, said the commission panel, which included the chair and vice-chair of NHS England’s mental health taskforce.

It voiced concerns, too, over the way patients and carers from black and minority ethnic communities are treated by health services and says staff need training to tackle racism as well as cultural and ethnic differences.

Lord Nigel Crisp Blog Screen Shot

Former NHS chief executive Lord Crisp headed the commission. Photograph: Martin Argles for the Guardian


Mental health trusts have in recent years suffered reductions in income, while trusts treating patients for physical health problems have generally seen increases, the report says.

Leaders of the leading mental health charity Mind, and the NHS’s own organisation for service providers, Mental Health Network, welcomed calls to end the “postcode lottery” of present arrangements.

Reductions in acute hospital beds – there were about 6,150 left for adults in England last year – reflected a long-term policy of providing more care outside wards, but the commission said any further cuts should depend on good care being available elsewhere, especially from specialist “crisis resolution and home treatment teams”.

It said the decline in bed numbers and greater use of those left meant many services had raised the medical threshold that potential patients had to pass. This meant only the most unwell or those presenting the greatest risk to other people were admitted.

“It is time to end the difference in standards between mental and physical illnesses,” Crisp said. “People with severe mental illnesses need to find care just as quickly as people suffering from physical illnesses – and they shouldn’t have to travel long distances to do so.”

Simon Wessely, president of the the Royal College of Psychiatrists, was blunter. “Everybody agrees it is a scandal that patients with mental health problems who need admission can end up being sent anywhere from Cornwall to Cumbria in search of a bed. And yet it continues.”

Experts would not even have to ask for an end to the unacceptable practice of sending seriously sick patients around the country “if we were talking strokes, hearts attacks or cancer”, said Wessely.

“The answers lie not just in providing more beds, although there are definitely places where that might help in the short term, but assessing the whole system.”

Paul Farmer, of charity Mind, said: “It is unacceptable that people who are feeling suicidal or who may have self-harmed and are in desperate need of care find themselves trekking hundreds of miles across the country to get help …

Paul FarmerPaul Farmer, chief executive of Mind. Photograph: Graham Turner for the Guardian


“It is so important that people can get the help they need within their own communities. When you are at your lowest ebb, feeling scared, vulnerable and alone, your family and friends form a vital support network that is really important to recovery. Local commissioners and providers must make sure that sufficient beds are available to meet demand.”

Stephen Dalton, chief executive of the Mental Health Network, the organisation for service providers, said: “Government rhetoric about prioritising mental health does not match the reality of shrinking funding and hardworking staff struggling to cope with growing public need.”

Lack of funding for some mental health services in England was putting vulnerable people, including children, at risk.

“The report rightly says this is not just about beds but is about understanding why people are admitted and why it can be difficult to discharge some people.” Dalton said. “The real answer is to ensure people can get care when and where they need it most.”

Luciana Berger MP, the shadow minister for mental health, said: “The commission rightly highlights staffing shortages, unacceptably long waits for care and the unacceptable practice of sending very ill patients hundreds of miles just to get a bed – something which has significantly increased on this government’s watch.

“Ministers must now respond to the robust recommendations set out by the commission and bring forward the urgent action needed to tackle these serious problems.”

Alistair Burt, minister for mental health, said: “It’s vital that people get the mental health care they need as quickly and as close to home as possible.

“Last year, I asked NHS England to reduce unnecessary out of area treatments, and eliminate their inappropriate use. We agree that there should be standards for what people can expect from mental health treatment, and when. NHS England and others will be working on this over the coming months.”

David Cameron has pledged increased mental funding totalling £1bn from different sources over a number of years and NHS England is expected to publish a report on improvements that are needed next week. Total spending on all adult mental health services in England in 2011-12 was £6.6bn, according to Crisp’s report.

This article was amended on 9 February 2016 to remove the headline reference to the UK. The inquiry was into services in England.

Credit: the Guardian

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