Expanding local capacity in Preston to reduce out of area placements

Key benefits and outcomes:

• 85 out of area placements avoided
• Greater continuity of care, post-discharge
• Lower-than-average length of stay due to better integration with community teams
• Savings of approximately £250,000 from reduced length of stay alone

Overview

The Priory in Preston collaborated with local NHS teams to coproduce a 12-bed acute inpatient mental health ward for adults, which reduced out of area placements while improving patient outcomes and service efficiency.

What the organisation faced

Priory, the UK's largest independent mental health and social care service provider, identified a growing number of NHS patients being treated out of area due to limited local inpatient capacity. This was particularly evident in areas surrounding Priory hospitals such as Preston. High levels of out of area placements (OAPs) were disrupting continuity of care and disconnecting patients from family and community support networks. NHS providers faced barriers to capital funding, slowing their ability to respond to demand.

What the organisation did

To address this challenge, Priory invested £4.5 million to develop a 12-bed acute inpatient mental health ward for adults in Preston. Priory took on the financial risk of development without a guaranteed NHS contract. To mitigate this risk, the organisation engaged local mental health commissioners early in the design process to ensure the service would meet NHS patient needs.

Because of Priory's access to capital, the development was able to proceed quickly and the close collaboration with local NHS teams allowed for coproduction of the new unit. This way of working means the service can operate as part of the local health economy rather than solely offering spot purchased beds. This leads to better continuity of care and shorter stays because the service is well-linked with other local services to support discharge. When new units are able to bring patients back into area, this is better for patients, who are closer to their home networks, and for community teams, who can visit their patients more easily.

Results and benefits

The new ward has been fully utilised since opening, exclusively serving local NHS patients. At the time of writing, 85 out of area placements have been avoided in the area, and patients now receive care closer to home. Better integration with community mental health services has led to improved discharge planning and reduced lengths of stay. The saving relating to a reduction of length of stay alone are approximately £250,000.

Takeaway tips

• NHS commissioners should view independent providers as potential partners in solving local inpatient capacity issues. Proactive risk-taking by an independent provider was able to overcome capital access challenges in Preston.
• Coproduction and early engagement are key to success. Having open and mature conversations with system partners is important for identifying opportunities.