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Mental health trust’s pledge to eradicate out of area placements by 2021

Hellesdon Hospital, NSFT headquarters. 

Picture: James Bass

Hellesdon Hospital, NSFT headquarters. Picture: James Bass

Archant Norfolk Photographic © 2009

The region’s mental health trust has pledged to eradicate the use of out of area beds by 2021.

The ambitious claim follows broken promises over the last few years but the organisation said it is confident the goal will be achieved this time around as more detailed and comprehensive plans were in place.

Norfolk and Suffolk NHS Foundation Trust (NSFT) has been hamstrung by a lack of beds for many years, meaning when a patient needs to be admitted to hospital they can be sent hundreds of miles away or to a private hospital.

In some cases patients were kept in police cells for longer than they would have been due to a lack of beds.

Or in the case of 42-year-old Neil Jewell, from Norwich, when a bed was not available in 2014 he was instead placed in a care home, where his condition deteriorated.

Neil Jewell in Sheringham. Photo: Christine WelfareNeil Jewell in Sheringham. Photo: Christine Welfare

He later died in hospital.

MORE: Why Norfolk police are having to keep mental health patients in cells for up to 68 hours



During 2013/14, 113 patients were sent to out of area (OOA) inpatient beds, outside of Norfolk and Suffolk, at a cost of £1.5m.

By the following year this had risen to 279 - a 272pc increase from the 79 patients sent away in 2010/11.

The most recent figures showed patients spent 8,585 bed days outside of the trust in 2017/18 at a cost of £5.4m.

MORE: More mental health beds could be opened in Norfolk - if commissioners grant the funding



But commissioners agreed to cover any costs above NSFT’s £996,000 budget - an arrangement in place for this year too.

And pressure is only set to increase as the trust has closed 36 beds - 28 temporarily - since autumn last year.

An NSFT spokesman said two new OOA placement managers had been recruited to help bring numbers down.

He said: “They monitor bed requests to keep patients within area, wherever possible, and where patients have to go OOA due to the lack of beds locally we look to bring them closer to home as soon as possible.”

MORE: First glimpse at plans for crisis hubs aimed at tackling mental health bed shortage



But commitments to stop OOA placements have been made before.

In January 2014, NSFT bosses said they would stop sending patients out of the area for treatment within four months.

This was not achieved and more recently the trust set itself the goal of to October 2017, before being adjusted to the “more realistic” date of March this year.

This was again missed but now national targets have demanded all mental health services stop sending patients OOA by 2021.

MORE: Revealed - The changes taking place at the region’s mental health trust in bid to improve



This time around the trust said a more detailed plan meant they were confident they could succeed.

The trust said a number of steps were being taken to ensure the 2020/21 target was reached.

The first involved introducing a bed management system on NSFT’s computer system, Lorenzo, and managers had also been recruited to oversee OOA placements.

A review was planned for the management structure of the central Norfolk acute team.

MORE: Mundesley Hospital’s shock closure following damning care quality report



Partial hospitalisation was also going to be introduced across all NSFT wards - this is where treatment is more concentrated than outpatient care but patients don’t stay overnight at hospital, and therefore do not need a bed.

Like much of the NHS many beds at NSFT are taken up when patients cannot leave due to social care not being arranged. These cases are known as delayed transfers of care and are being reviewed by NSFT, including bringing in executive trust members to tackle the issue.

Any delays in the discharge process are being looked at and already seven beds have been commissioned as step-down beds to help people get home.

Also set to be introduced are a dedicated personality disorder provision, community wellbeing hubs, and a new project on patient flow.

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