Scotland's mental health watchdog is calling for there to be more emphasis and investment in supporting people who have been placed in care settings outside their own communities to return home.

In a report on people with significant mental illness or learning disabilities placed 'out of area', the Mental Welfare Commission for Scotland makes a series of recommendations for the NHS.

The Commission says inconsistent data collection means estimates of the costs of care far from home are likely to higher than estimated – and the NHS nationally needs to have better oversight and scrutiny.

162 individuals whose homes are in Scotland are being cared for outside their own health board area, and mainly in private sector facilities. Most of these facilities are in Scotland and a few are in England.

The Commission’s report focuses on 59 people who had been cared for away from home for an average of eight years, with one person having been cared for out of their own area for 28 years.

The Commission says the people concerned and their relatives told the review team the care they were receiving was good and often better than what they had experienced before moving.

However, they also talked of a continuing impact on relatives and family from not being close to home.

The review team say they found it difficult to get accurate information on the cost of care and treatment placements to NHS Scotland, suggesting that their own estimate of the £13m a year for the 59 people in question was likely to be "very conservative".

The Mental Welfare Commission for Scotland says those placed out of their own NHS health board area are likely to have highly complex, specialist needs that couldn’t at the time be met by their local health services.

Executive Director for Nursing, Clare Lamza says there needs to be an emphasis on planning to provide the care needed closer to people's homes:

“We were reassured to hear positive feedback from individuals and relatives on the quality of care, but we also heard they were unsure of the plans that were being put in place for a return closer to home and about the impact on relatives of travelling to see their family member, and the toll that this took on their relationship.

“Our recommendations include setting new standards, developing accurate data collection and creating a national oversight and scrutiny role.”

As well as recommendations around improved data gathering and scrutiny by a national NHS body, the report calls for the adoption of multiagency discharge planning standards; and the development of structured plans, led by each person’s home NHS board, to support rehabilitation and engagement back into their local communities.

Ms Lamza says the Scottish government needs to look at a regional approach where health boards work together to provide care closer to people’s homes:

“We also asked Scottish government to take a human rights and health economics-based approach and consider whether a regional resource should be developed for those individuals who are considered at greatest risk of being out of area.”

Read more: Landmark moment for Coming Home campaign; New push to help patients "lost in system"; Go ahead for vulnerable teenagers’ inpatient unit;

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