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Children travelling up to 200 miles for ‘in-area’ mental healthcare

A major doctors’ group has today accused the government of misleading the public as it changed its definition for out-of-area beds for vulnerable children with mental health problems.

The British Medical Association (BMA) raised concern that children and young people with mental health problems are having to travel more than 200 miles from their home for their care to be considered as ‘out-of-area’ (OOA). This equates to a patient being taken from Cornwall to Gloucester for their care.

A 2014 report defined OOA placements as those “where young people are harmed by the distance and disconnection from local services, families and friends”. Then in 2015, this definition was changed to being based on ‘commissioning hubs’ which have the same boundaries as NHS regions.

But using regions like this can encompass several English counties and numerous CCG areas, meaning that some patients are counted as being treated in-area when they are being taken miles from home.

This is despite the fact that NHS England earlier this year told the BMA that it had “toughened up” its stance on the definition for children and adolescent mental health services.

“Patients and their families who are forced to travel for hours and hours to hospital will not have their beds counted as out-of-area. This is a very real harm that is not being accounted for,” said Dr Gary Wannan, BMA consultants committee deputy chair and child and adolescent psychiatrist.

“It can be an incredible wrench for children to leave their homes and families; being based far away is not going to help a young person in crisis.”

Doctors welcome the government’s ambition to end OOH placements but this way of keeping track of the problem is all smoke and mirrors, Dr Wannan concluded.

The BMA added that under the new definition, 1,365 children and adolescents were admitted to beds outside their region in 2016-17.  Of these, less than half (627) are deemed to be for ‘capacity reasons’ and so are officially declared as OOA.

A spokesperson for NHS England argued that mental health services for children were expanding at their fastest rate in over a decade, including new and enhanced eating disorder teams with shorter waits for specialist care and a major increase in specialist inpatient facilities in underserved parts of England.

“Improving mental healthcare for children and young people is an absolute priority for the NHS and although transformation won’t happen overnight work is well under way to make sure the right care is available at home or as close to home as possible,” they added.

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