People placed in locked in-patient wards for serious mental health problems are more likely to face lengthy stays far from home and local support, a report from regulators the Care Quality Commission has found.

An information request to providers found that nearly two thirds (63%) of placements in residential-based mental health rehabilitation services are ‘out of area’, which means they are in different areas to the clinical commissioning groups (CCGs) that arranged them, miles from their family homes.

The majority (78%) of ‘out of area’ placements are with independent sector providers rather than the NHS.

The CQC has found from its inspections that the quality of care in residential mental health rehabilitation services is very similar between NHS and independent sector providers.

However, CQC’s review shows that people in residential mental health rehabilitation services provided by the independent sector are, on average:

• More likely to be further from their homes than those staying in NHS services – 49km compared to 14km.

• More likely to stay there for longer – 14.5 months on their current ward compared to 7.5 months on their current ward in a NHS service.

• At a greater risk of having their aftercare compromised because the managers there are less likely to know which NHS trust would care for them following discharge – 99% of managers of NHS rehabilitation services were able to name the NHS trust that would provide their patients’ aftercare, in comparison to 53% for independent services.


Dr Rajesh Mohan, chairman of the Royal College of Psychiatrists’ rehabilitation faculty, said: “That nearly two thirds (63%) of placements in residential-based mental health rehabilitation services are out of area is deeply worrying."

“As with any mental illness, rehabilitation patients should only be treated out of area if they need access to specialist services."

“The reason more and more patients are being sent inappropriately out of area is because NHS rehabilitation services have been closing at an alarming rate - in 2009 there were more than 130 such services in England; by 2015 that number had fallen by a third to just 82."

“Patients treated many miles from home take longer to recover partly because they don’t have ready access to their friends and families, whose support is so vital in aiding their recovery."

“That’s why we’re calling on the Government to reverse this alarming trend and ensure every part of the country has comprehensive inpatient and community rehabilitation services. That way, as many patients as possible would be treated locally."

“This report highlights what we have known for many years – that long-stay, locked rehabilitation services have no therapeutic value and can be hugely expensive.”