Children and parents are being forced to travel hundreds of miles to access care which is classed as 'local' by new government definition.
The government has been accused by a doctors’ group of attempting to bury a crisis in the NHS by changing the definition of out-of-area beds for children with mental problems.
Children and adolescents with mental health problems can travel more than 200 miles from home — such as from Cornwall to Gloucestershire — to receive care and still be classed as ‘in area’, the British Medical Association (BMA) has uncovered.
Previously, NHS England defined OOA (out-of-area) treatment as ‘where young people are harmed by the distance and disconnection from local services, family and friends’.
Under the old definition, seven in ten children with mental health problems were treated outside their local area in 2016, the BMA found.
This old definition officially changed in 2015 to one based on NHS regions: if you’re sent out of your NHS region for care, you’re classed as out-of-area. NHS regions are large geographical areas, encompassing several English counties and clinical commissioning groups.
So, if you’re not sent out of your NHS region, you’re classed as being treated locally even if you have to travel hundreds of miles for care, the new rule says.
The BMA, who uncovered the changed definition through a series of Freedom of Information (FOI) requests, accused the government of ‘smoke and mirrors’.
“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 BMA spokesperson and adolescent consultant psychiatrist Gary Wannan, who added:
“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”
There is a growing crisis in mental health care for children and adolescents in the NHS:
- Seven out of ten children with mental health problems were treated out-of-area (under the old definition) in 2017, a rise of 12 per cent from the previous year.
- Entire regions of the NHS were left without any inpatient mental health beds for children on three occasions last year, a report found in July.
- Overall, demand for mental health beds for children in some regions has grown by over fifty per cent in recent years.
Redefining what local means in terms of mental health care for children appears to be a cynical attempt by the government to cover up this crisis.
In terms of adult mental health care, the NHS still uses the old out-of-area definition, which is: ‘the person cannot be visited regularly by their care coordinator to ensure continuity of care and effective discharge planning’.
It seems there’s now a huge gap between children’s mental health services and adults. “Inequality within mental health services is concealed by changes in the way statistics are presented”, the BMA said. Dr Gary Wannan added:
“It’s simply shocking that this measure is looser for children and young people than for adult patients”
Out-of-area care for adults is a growing crisis in the NHS. Last year, almost 6,000 patients were sent out of their local area for treatment, a rise of 40 per cent in two years, figures showed.
Changing the definition of out-of-area care for children appears a cynical move by the government to conceal a massively growing crisis.
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