The latest report from the NHS Confederation, produced in partnership with the Royal College of Psychiatrists, lays bare a reality many of us working in mental health have long known.
Providing mental health care as close to home as possible should be a foundational principle of the system, not an aspiration dependent on geography or chance. Outcomes are better when people can maintain contact with loved ones, when local clinicians remain involved, and when discharge planning is rooted in familiar community services.
Care close to home also supports flow across the pathway, reducing delayed discharges, repeat admissions and pressure on emergency departments.
Currently there are hundreds of available beds in the independent sector that aren’t being utilised despite the fact people are facing unacceptably long waits in A&E departments. We see police officers spending prolonged hours ‘patient sitting’ in A&E, diverted from their emergency frontline duties protecting the wider public. Yet utilising available capacity in the independent sector can help to keep people in area and alleviate this pressure on our emergency services and staff.
The report rightly identifies that reducing IOAPs requires improved access to capacity and flow across the entire mental health pathway. That’s why we stand as committed partners to the NHS.
The independent sector has a vital role to play as a long-term, strategic partner, bringing additional capacity, specialist expertise and the ability to respond at pace to areas of greatest need. This is not about replacement, but about collaboration. It is about aligning around shared standards, shared outcomes and shared responsibility for patients.
When the NHS and independent providers plan together, we can ensure beds are available where they are needed, when they are needed, and closer to the communities patients call home.
Cygnet has made a significant contribution already, investing in the mental health ecosystem where demand exists, and increasing bed capacity in new hospitals to support this ambition. Over the past two years, we have expanded our network and opened seven new hospitals, increasing local capacity in regions where demand has consistently outstripped supply.
This expansion is about responding to real pressures within the system and helping commissioners keep people as close to home as possible. Every new hospital represents an opportunity for someone to receive high-quality care nearer to family, support networks and home-based services.
The direction set out in the NHS 10 Year Plan, with its emphasis on prevention, community provision and integration with housing and social care, is the right one. Shifting resources upstream will help keep people well and out of hospital wherever possible.
But even with stronger community services, there will always be a need for inpatient care. The challenge is ensuring that inpatient care is timely, appropriate and local. That requires realistic planning for bed capacity, better use of all available providers, and a system-wide commitment to utilise all beds across the mental health care system.
IOAPs are not the result of individual failure; they are a system issue, and they demand a system response. By working together, investing intelligently and keeping the needs of patients and families at the centre of every decision, we can move from managing the consequences of capacity gaps to finally closing them.
Care close to home must become the norm, not the exception. The patients we serve deserve nothing less.