A mental health trust forced to free up inpatient beds by discharging patients into bed and breakfast accommodation has seen its bill for the measure rocket five-fold in less than a year.

London-based Barnet Enfield and Haringey Mental Health Trust saw the cost of moving discharged patients into B&Bs shoot up from £46,000 in 2012-13 to £264,000 in the 10 months to January this year.

The use of B&Bs, which the trust admits was “not ideal for patients”, was revealed in a freedom of information response which also shows an 11-fold hike in the trust’s bill for placing patients with private providers.

This budget shot up from £89,000 in 2012 to almost £1m in the first 10 months of 2013-14, with each bed costing the trust around £800 a night.

Only patients well enough to be discharged from a ward but who lack a suitable place to stay are placed in B&Bs.

The trust’s escalating use of B&B and private provider accommodation comes after it reduced inpatient beds by around a third over the past five years, in line with other NHS providers.

The use of out-of area-placements – in which a patient in need of a bed is sent to another provider – has been increasing across the mental health sector as bed numbers drop and demand increases.

The number of mental health beds has fallen 32 per cent from 2003 to 2013 while the number of detentions under the Mental Health Act increased by 6 per cent from 2003-04 to 2011-12, HSJ revealed in October last year.

Andrew Wright, director of strategic development at Barnet, Enfield and Haringey Mental Health Trust, told HSJ that demands on the trust were common for mental health providers across the country.

He said B&B accommodation was provided only when “absolutely necessary”.

“This is not ideal for patients… however, it does help in ensuring that we have acute beds available when required,” he said.

He added: “The current situation has improved, however, the numbers of patients requiring admission continues to fluctuate, so although the pressures on our beds has reduced, we anticipate they could increase again over the coming months.

“We will be working together to further improve the processes for managing patient care pathways and on longer-term approaches to meeting increased demand for our services within the constrained resources available.”

Mental Health Network chief executive Stephen Dalton said specialised commissioning of mental health beds across the country had become a major concern.

“It is quite clear that specialised commissioning is in freefall and nobody is getting a grip of it,” he added. “Patients are in the wrong beds in the wrong places and providers up and down the country are complaining about it.”

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