This report is a follow-up to our 2018 briefing on mental health rehabilitation inpatient services.
These services are an essential element of our mental health care system. They provide people with complex psychosis, or other serious mental health problems, with specialist assessment, treatment and support.
We are concerned about the high number of beds situated a long way from the patient’s home. This could result in people becoming isolated from their friends and families and cut off from the local services that will provide care following discharge.
What we did
In 2017 we asked providers to tell us about the mental health rehabilitation inpatient services that they manage. As a result of our information request, we made a number of recommendations for improvement.
In 2019, we sent a second request for information to 114 providers to review progress. The information request asked about:
- the number of wards and beds designated as providing inpatient mental health rehabilitation care, and the number of people were occupying a bed
- the length of time people had been on an inpatient rehabilitation ward, and in inpatient rehabilitation care in other services
- how far are these patients were from home
- who was funding their care and who would care for them after discharge from hospital.
What we found
Although our information request was only a snapshot in time, we are concerned that:
- there had only been a small increase in number of people receiving rehabilitation care close to home
- too many people continued to be sent far from home for treatment
- people being cared for by independent providers are still staying longer in hospital, and are further away from home, than those in NHS services
- a high number of wards continued to identify as locked rehabilitation – this is against the least restrictive principle and potentially represents a breach of human rights.
Our recommendations
Based on the results of our 2019 information request, and in line with the recently published NICE guidance for the rehabilitation of adults with complex psychosis, we make recommendations to improve the care for people in mental health rehabilitation inpatient services.