Mental health rehabilitation inpatient services: Ward types, bed numbers and use by clinical commissioning groups and NHS trusts

Care Quality Commission, March 2018

Report from the Care Quality Commission looking at mental health rehabilitation inpatient services that finds:

  1. People are often receiving care a long way from where they live and from their support networks, which in turn can affect their onward recovery and wellbeing.
  2. People are being accommodated in services that are ‘dislocated’ from their home areas. This is more prevalent in the independent sector than in NHS services on average (49km) compared with NHS patients (14km).
  3. The independent sector
    1. Provided more wards that were categorised as either locked rehabilitation or complex care (75% of wards of this type) and fewer wards categorised as long stay, community or high dependency (25% of beds of this type).
    2. Accommodated patients who had been on that particular ward for longer (median 444 days compared with 230 days in the NHS) and in hospital continuously for longer (median 952 days compared with 492 days in the NHS).
    3. Because of the longer length of stay, accommodated patients whose current placement had cost twice as much (median £162K compared with £81K)

4. There is very wide variation between CCG areas in the use of rehabilitation beds, and in the use of beds that are out of area.
The report estimates that the annual expenditure on mental health rehabilitation beds is about £535 million. Out of area placements account for about two-thirds of this expenditure.   The 10% of CCGs that fund the highest number of places are spending an average of at least £19,000 per day on this element of provision – of which £8,200 is spent on independent sector provision; the majority of which is out of area.

Click here to view the full report.