This toolkit aims to support health, social care and housing commissioners to develop and commission services that are as close to home as possible for people using mental health services and their families.
Out of area services make up a considerable proportion of mental health and social care provision and expenditure.
This toolkit provides a framework for understanding the use of services out of area; what might contribute to their usage; and how taking a whole system approach could reduce the use of such services.
The toolkit is intended to contribute to local actions to improve quality and individual/system outcomes by:
- Limiting the number of people placed inappropriately
- Reducing the number of people placed at distance from families and social networks
- Minimising the length of time that people spend in out of area services
- Maximising and improving care coordination and monitoring of placements
- Specifying services to actively promote independence
- Encouraging services to be commissioned on a needs basis, at appropriate costs and within commissioning resources.
A summary of research and knowledge in this field is provided to give best evidence of the current picture and some of the issues associated with use of placements out of area.
A systematic seven-step framework to reduce the need for out of area services is described. This should support commissioners to consider the processes and actions that others have found helpful in improving their local performance and outcomes. Embedded within the toolkit is a range of tools that have been developed and used successfully across the country.
A series of case studies are also described where people have successfully reduced the need for unplanned use of out of area services. These contain contact details of key personnel who are prepared to provide further information about their work, if required.