The NHS pays £2 billion a year to private hospitals for mental health patients | NHS

The NHS The Guardian pays £2 billion a year to private hospitals to care for mental health patients because they do not have enough beds of their own, the Guardian could reveal.

The independent sector receives about 13.5% of the £14.8 billion NHS England spends on mental health, a significant increase since 2005 when £951 million was paid out. Nine out of 10,123 mental health beds run by private operators are occupied by NHS patients.

The NHS’ growing reliance on independent providers comes despite concerns by some health service chiefs that there are persistent – and sometimes fatal – problems with the quality and safety of care in many of the mental health units they run.

These concerns, shared by NHS psychiatrists, mental health nurses and charities, are confirmed by reports of inspections by the Care Quality Commission (CQC). Figures she provided to the Guardian show that 71 different psychiatric facilities run by non-NHS providers looking after adults or those under 18 have been found to be ‘inadequate’ since the start of 2017 – more than one in four out of a total of 269 of this. kind. units.

According to the latest research by health market analyst LaingBuisson, independent mental health providers receive £1.964 billion annually to treat NHS patients. They have gained a dominant role as the NHS has reduced its own stock of mental health beds despite the growing demand for residential psychiatric care.

The disclosure of NHS delivery in England to independent operators paid such a huge sum of money to Dave Munday, Mental Chief Professional Officer. health The Nurses’ Association, to denounce the “blatant privatization of services on which the most vulnerable depend for survival.”

Mind’s chief executive, Paul Farmer, said the “dangerous drawdown” of the NHS family in recent years had made it worryingly dependent on the private sector.

“While this use of private providers is not in itself of concern, the fact that some patients are being transferred to private providers halfway across the country, or actually providers that the HQC has deemed to be providing Inadequate standards of care, is incredibly worrying, particularly as some of these referrals appear to have led to tragic and fatal consequences,” said Farmer, who chaired the NHS England mental health task force in 2015.

LaingBuisson’s research also shows that:

  • Independent mental health care providers now get 91% of their income from the NHS.

  • Typical profit margins are 15%-20%.

  • The majority of inpatient care is now outsourced to those under 18, with independent operators taking care of 55% of all children and young adults admitted to hospital.

  • Non-NHS providers earn £316m a year treating children and young adults.

In general, the four largest operators – for-profit companies Cygnet Health Care, Priory Group, Elysium Healthcare and St Andrew’s Healthcare charity – receive 1.356 billion pounds – two-thirds of the total amount of about 2 billion pounds. This reflects that they operate 182 hospitals containing 6,700 (66%) of the total independent sector of 10,123 mental health beds. In another sign of their dominant role, the Quartet own nearly 40% of all safe mental health beds in England, and are for the sickest patients.

While private sector beds increased from 9,291 in 2010 to 10,123 in 2021, the number of mental health beds in the NHS fell from 23,447 to 17,610 – a decrease of 5,837.

The NHS watchdog gave 10 of 71 ‘unfit’ hospitals the lowest rating twice when CQC inspectors found, on return visits, that urgent improvements they had ordered to improve care for people with conditions such as psychosis and bipolar disorder were not being made, with patients still being exposed. at risk.

Dr Andrew Molodensky, Head of Mental Health Policy at the British Medical Association, said: “The persistent lack of government funding for NHS services and failure to address the mental health family shortage has led to an alarming over-reliance on private providers, many of whom have been responsible for a catalog of safety failures. patient, putting high-risk patients at increased risk of inadequate care or, in the worst cases, self-harm and suicide.”

The Big Four operators from outside the NHS said staffing problems were hampering their efforts to always provide the best possible care to patients with often difficult and complex illnesses, and that only a small number of their facilities were rated as inadequate.

A spokesperson for Priory said: ‘Priory’s work in partnership with the NHS and availability of independent mental health services enables the NHS to give very sick patients immediate access to treatment that they often lack appropriate facilities, or the ability, to provide themselves, as well as free of charge.’ much needed and occupied patients who require specialized mental health treatment.”

A Cygnet spokesperson said the safety and well-being of service users was its “absolute priority,” adding that 82% of its facilities were rated “good” or “outstanding” by regulators.

Elysium said it was proud to provide care to people at “the most vulnerable point in their lives.” “While we take great pride in the ground-breaking care and treatments we provide across our hospitals, we never stop striving to learn and improve,” she added.

Jes Livesley, chief executive of St Andrew’s, said that while five of the nine services it operates were rated “good” by the CQC, three were rated “requiring improvement” and one as “inadequate”.

“This is not the level of service we are satisfied with and we have restructured our charity over the past few years to drive improvements in the quality of care we provide,” he said. This included reducing the number of beds it occupies by a third and increasing investment in community mental health services.

An NHS England spokesperson said: “The NHS has been clear that we expect all services to provide safe, high-quality care and to fulfill our obligations in their contracts, regardless of whether it is the NHS or an independent sector led.”