Wessex AHSN and NHS South, Central and West Commissioning Support Unit (CSU) are working with the Hampshire and Isle of Wight Sustainability and Transformation Partnership (HIOW STP) to explore patient activity data from across the STP in order to better understand out of area placements (OAPs).
The National Picture:
OAPs occur when a person requiring adult mental health acute inpatient care is admitted to a unit that does not form part of their usual local network of services. There are a number of reasons why admitting someone ‘out of area’ may be appropriate, however, an ‘inappropriate OAP’ occurs when the person is sent out of area primarily because there is not a bed available for them locally.
Moving a person away from their familiar local surroundings and their support network of friends, family, and carers can delay their recovery. An OAP also prevents the person being visited regularly by their care co-ordinator to ensure continuity of care and effective discharge planning.
Inappropriate OAPs are also expensive; according to NHS Digital OAP data collection between 1st August 2018 to the 31st July 2019 inappropriate out of area placements in England cost the NHS over £125 million1.
Addressing the Challenge:
The government has set a national ambition to eliminate inappropriate OAPs in mental health services for adults in acute inpatient care by 2021.
In line with this objective, HIOW STP have been undertaking a review of inpatient and community provision with the aim of improving outcomes for adults and older people using acute mental health services and eliminating the inappropriate use of out of area placements.
In order to inform this review, we have been working in partnership with NHS South, Central and West Commissioning Support Unit (CSU) and data analysts from the local NHS trusts. Together we are exploring data from across the acute care pathway to support the HIOW STP with service planning.
1 Statistics from NHS Digital’s ‘Out of Area Placements in Mental Health Services’ report, which was published on the 10th October 2019.