Referrals to largest private provider halted

Southern Hill Hospital in Norfolk provided more than 18,000 bed days classed as OAPs for NHS patients last year, with Greater Manchester Integrated Care System being the main contributor to that total.

However, HSJ has learned that GM’s integrated care board and mental health providers have decided not to send any more patients to the provider.

The move comes after a recent visit to and review of the service at Southern Hill by GM commissioners. This, in turn, followed concerns about the “co-ordination” of patient care at Southern Hill received by GM. The exact nature of the concerns is unclear, and the ICB said in a statement “no significant safety or quality concerns were found and feedback from patients was positive”, when it carried out its review.

The ICB said the decision to cease placements at Southern Hill shortly after the concerns were raised was a coincidence, and that the move was part of its strategy to reduce OAPs.

Asked whether placements would also cease at other OAP providers, including at facilities as far away as Surrey, Lincolnshire and Somerset, the ICB declined to comment. The system’s 2024-25 operational plan assumes demand for inpatient beds will continue to exceed the bed stock within GM.

Southern Hill, which the Care Quality Commission rated “requires improvement” in 2022, said it had contacted the ICB since the decision to halt referrals, to understand any issues, but had not received a response.

Southern Hill accounted for around a quarter of GM’s OAPs in recent months. The system’s use of OAPs has soared over the last year, and it accounted for almost one in six cases nationally in the three months to February. The cost of these placements over the three months was around £9m.

The surge in demand within the GM system came soon after dozens of medium-secure beds were suddenly closed in 2022, following the patient safety scandal at the Edenfield Centre in Bury, run by Greater Manchester Mental Health Trust. These beds remain closed.

An internal document seen by HSJ last year said GM was in the top quartile in terms of mental health care “need”, but in the bottom quartile for spending per head.

Greater Manchester ICB’s chief medical officer Manisha Kumar said: “Part of our strategy is to reduce the use of [OAP] providers furthest away from Greater Manchester. One of these providers is Southern Hill hospital.

“Additionally, concerns were raised to NHS GM in March 2024, in relation to the coordination of care for patients at Southern Hill hospital. In response, we moved forward our plans to visit Southern Hill, and our patients placed there, to review their care and treatment. No significant safety or quality concerns were found during these visits and feedback from patients was positive.

“In line with our OAPs reduction plan, we have made the decision to not place any further patients in Southern Hill hospital. However, we will continue to work with them to ensure that our existing Greater Manchester patients (around 19) are having their needs met and, as is usual practice, will be looking to safely transition them back to Greater Manchester as soon as possible.”

The ICB said OAPs had started to reduce in recent months and added: “We are working on a preferred provider list for a consistent approach towards out of area placements. By considering factors such as proximity to home, continuity of care, and community engagement, we can establish a comprehensive and responsive mental health care system that meets the diverse needs of individuals and communities.”

Essex Partnership University Foundation Trust, which has also sent large numbers of cases to Southern Hill Hospital recently, said it was in contact with GM to understand what concerns had been raised.

Southern Hill was previously known as Mundesley Hospital (and is still referred to as this in some official NHS datasets). Mundesley was rated “inadequate” and placed in special measures in 2016. It was subsequently closed and reopened under a new name and new owners, Southern Hill Ltd.

In the year to February, Southern Hill provided more than 18,000 out-of-area bed days to the NHS, making it the largest single-location provider of OAPs in England.

Southern Hill said in a statement: “We note that NHS Greater Manchester found no significant safety or quality concerns during their visits and are pleased to hear that patient feedback was positive. We had contacted Greater Manchester ICB and Manchester mental health team to understand their specific concerns but so far, we have not received any response. We will remain in discussions with NHS GM, as we are keen to better understand this decision and next steps, whilst continuing to prioritise patient care, which remains our focus.”

The CQC confirmed it had held an unannoucned insoection of the provider recently, with the assessment process ongoing. Southern Hill said initial feedback had been positive.