First reported 21 May 2021•Latest report 19 Sep 2023
Definition
What this concern includes
Includes failures in the end-to-end process for managing out-of-area patients who may be ready for step-down, repatriation or transfer to an available appropriate bed, including maintaining accurate patient and placement information, assessing vacant-bed availability, recording and progressing allocation discussions, coordinating with receiving or local services, and managing cross-Trust referrals where these directly affect timely bed allocation or repatriation.
Not included
Excludes general clinical-record deficiencies where the records do not concern out-of-area patient placement, bed allocation or repatriation.
Excludes ordinary hospital bed shortages without an out-of-area patient, repatriation or cross-Trust allocation context.
Excludes delays in treatment, discharge or transfer after a suitable bed has been allocated and the out-of-area allocation process is no longer deficient.
Excludes generic inter-agency communication or care-coordination failures that do not concern allocation or repatriation of out-of-area patients.
Excludes the broader continuity-of-care concerns associated with out-of-area mental health placements where no bed-allocation or repatriation failure is identified.
Reports
3
Distinct published reports
Individual concerns
5
A report can raise multiple concerns
Date range
2021–2023
First to latest report issue date
Stated actions
10
Described in published responses
Reports over time
Reports over time
Reports about this concern issued each year.
* 2026 is projected from reports observed to 7 Sep 2026.
Most frequent recipients
Most frequent recipients
Reports about this concern sent to each recipient.
Department of Health and Social Care2
Dorset Healthcare University NHS Foundation Trust1
Greater Manchester Health and Social Care Partnership1
NHS England1
NHS Greater Manchester Integrated Care Board1
Ministerial department2
Executive non-departmental public body1
Health-system partnership1
Integrated care board1
NHS trust1
Concerns and responses across reports
Only concerns grouped under this recurring concern are included. Select any concern, action or position to view the source wording.
Manchester South
Concerns raised1
Out-of-Area patients remaining away from home because of delayed discharge or repatriation
This report raised 8 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.10
Action
Develop and publish statutory guidance for discharge from mental health inpatient settings.
Stated by Department of Health and Social CareStated completedThe respondent said that this action was complete when they made their response on 13 November 2023.
Action
Provide additional funding to support adult social care and NHS discharges, including from mental health inpatient settings.
Stated by Department of Health and Social CareStated completedThe respondent said that this action was complete when they made their response on 13 November 2023.
Action
Work with NHS England to ensure systems prioritise eliminating inappropriate out-of-area placements, focusing on discharge and patient flow.
Stated by Department of Health and Social CareStated in progressThe respondent said that this action was in progress when they made their response on 13 November 2023.
Action
Work towards eliminating adult acute out-of-area placements across the NHS.
Stated by NHS EnglandStated in progressThe respondent said that this action was in progress when they made their response on 13 November 2023.
Action
Publish guidance supporting timely, local, high-quality therapeutic inpatient care and timely discharge.
Stated by NHS EnglandStated completedThe respondent said that this action was complete when they made their response on 13 November 2023.
Action
Support health and care systems to operationalise inpatient mental health care localisation plans through regional and national assistance.
Stated by NHS EnglandStated in progressThe respondent said that this action was in progress when they made their response on 13 November 2023.
Action
Add a dedicated Hospital Overview section identifying out-of-area patients requiring repatriation to support daily bed-allocation decisions.
Stated by Dorset Healthcare University NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 13 November 2023.
Action
Appoint a dedicated clinical Out of Area Coordinator.
Stated by Dorset Healthcare University NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 13 November 2023.
Action
Implement an out-of-area inpatient-care procedure requiring regular contact and documentation with patients, families, carers and treating clinicians.
Stated by Dorset Healthcare University NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 13 November 2023.
Action
Conduct monthly audits of out-of-area patient records against procedure standards, including coordinator input, care coordination, contacts, reviews and repatriation planning.
Stated by Dorset Healthcare University NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 13 November 2023.
Manchester South
Concerns raised3
Failure to record out-of-area patients’ identity and relevant circumstances timeously and correctly
Failure to assess out-of-area patients for available beds when vacancies arise
Failure to record discussions about allocating available beds to out-of-area patients
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
No linked response statements
No respondent-stated action or position is linked to these concerns in the published data.
Manchester South
Concerns raised1
Delays in cross-trust mental health bed allocation for patients outside the assessing trust’s commissioned area
This report raised 4 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
No linked response statements
No respondent-stated action or position is linked to these concerns in the published data.
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Includes failures in the end-to-end process for managing out-of-area patients who may be ready for step-down, repatriation or transfer to an available appropriate bed, including maintaining accurate patient and placement information, assessing vacant-bed availability, recording and progressing allocation discussions, coordinating with receiving or local services, and managing cross-Trust referrals where these directly affect timely bed allocation or repatriation.
