Hertfordshire NHS bodies spend massive sums sending mental health patients away for care

NHS bodies in Hertfordshire and west Essex have spent millions sending patients out of the area for acute mental health care, with one Herts trust alone having spent almost £800,000 since October.

Data released by NHS Digital last Wednesday (23 August) revealed that the Hertfordshire Partnership NHS Foundation Trust (HPFT) — which provides care for mental health patients across Hertfordshire and some neighbouring counties — had to send 35 patients out of area for treatment between the October 17, 2016 and June 30, 2017 at a cost of £760,495, with some patients having been sent more than 200km away.

The data — the latest in a series of new monthly reports on out of area placements (OAPs) in England — revealed that HPFT patients spent a combined total of 1,159 days on OAPs, at an average cost of £680 per day, with over £94,000 spent by the trust between the June 1 and June 30 alone.

The figures prompted Doug Swanney, chairman of the North East Herts Labour Party, to lambast what he described as a “desperately unfair situation” that saw local trusts unable to provide enough beds for patients, something he put down to “years of NHS under-funding by the Conservative Government, pressure to sell-off property and make billions of so-called savings.”

He added: “Sending patients far away from family and friends when they are unwell is far from ideal and sadly reflects the national picture.

“The Tories label funding cuts as ‘efficiency savings’ but it’s not efficient to have dedicated professionals struggling to find places for their patients and our local trust shouldn’t be put in that position.”

Approximately ten HPFT patients had spent more than 31 days out of their area by the time their placements ended, with at least five patients having been sent between 200 and 300km away for their care.

Elsewhere, the NHS East And North Hertfordshire Clinical Commissioning Group (CCG) spent £249,884 on approximately ten OAPs during the same period, while the NHS Herts Valleys CCG spent £538,404 on 20 OAPs.

In total, the Hertfordshire and West Essex NHS Sustainability and Transformation Partnership (STP) — an umbrella group that brings together individual trusts, CCGs and councils for a joint approach to planning health care — recorded a combined spend of £1,807,290 on 70 OAPs over the period.

A spokeswoman for NHS Digital confirmed that though some of the areas covered by the HPFT would be included in the area covered by the Herts and West Essex STP, the areas and subsequent data did not overlap perfectly, meaning some of the £760,495 spent by the HPFT may not be included in the figure recorded for the STP as a whole.

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The data includes both ‘inappropriate’ OAPs, where a lack of bed spaces locally necessitated patients being sent further afield for treatment, and those where the particular services required by a patient are not provided in their local area.

The HPFT was recently revealed to be planning the sale of two properties in Hemel Hempstead under Government plans to offload “surplus” NHS sites.

One of the properties — a two-storey, 3000 square metre building — is still in clinical use, with the community services currently offered there due to be relocated to a brand new centre towards the end of the year.

However, Sandra Brookes, managing director of the HPFT’s East and North Strategic Business Unit said it was “inappropriate to draw a link” between the sale of these properties and the trust’s expenditure on OAPs, as the buildings were “not suitable for acute mental health or intensive psychiatric” care.

She said: “At HPFT we have achieved a significant reduction in the number of out of area placements over the last couple of years.

“We believe service users should be treated in a location which helps them to retain the contact they want to maintain with family, carers and friends, and to feel as familiar as possible with the local environment.

“We always try to keep people as close to their homes as we can and not all out of area placements that we use are out of county; some are with private sector providers in Hertfordshire.

“Additionally, it is important to point out that there are some services that are not provided within Hertfordshire — an example is female psychiatric intensive care — so we will always have some out of area placements in order to provide the most appropriate care for an individual.

“We monitor out of area placements and keep in regular contact with the progress of service users with the aim of trying to bring them back into our services as soon as we can.”

Data obtained by the British Medical Association (BMA) earlier this year revealed that there had been a 40 per cent rise in patients travelling long distances for care across England, with NHS Trusts and CCGs spending £159 million on 5,876 OAP’s in 2016-2017 compared with 4,213 in 2014-2015.

Dr Andrew Molodynski, NHS consultant psychiatrist and mental health policy lead of the BMA’s consultants committee, said: “The practice of sending patients with severe mental health problems to beds hundreds of miles away from their home and families has become endemic in the NHS.

“The huge distances often involved rules out regular visits from friends and relatives at a time in their lives when their support matters most.

“There have been tragic cases where coroners have ruled that the difficulties families have visiting a relative receiving care, as well as poor communication between hospitals in other regions and local mental health services, contributed to deaths.”

The Government has said that it wants to eliminate inappropriate OAPs by 2021.

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