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Secure Psychiatric Units

Volume 464: debated on Wednesday 10 October 2007

To ask the Secretary of State for Health what assessment he has made of whether there is sufficient capacity in existing regional medium secure units to meet the need for such places in each region; in which regions there is an assessed shortfall; what the extent is of the shortfall in each case; and what plans are in place to address the shortfall. (156082)

Data on capacity for medium secure services are not routinely collected by the Department. The Department works to support local commissioners, as it is the responsibility of local commissioners to assess service needs in their area and plan accordingly. A capacity review of high and medium secure services was completed in January 2006 in order to inform policy on this issue and to help support commissioners. This capacity review took into consideration historical utilisation, changing legislation (e.g. draft Mental Health Bill and public protection orders), court sentencing trends, prison transfers and the needs of different patient groups (e.g. women, learning disabled men, patients with dangerous and severe personality disorder and deaf patients).

The review concluded that the need for medium secure capacity was gradually rising and robust local commissioning plans were necessary to ensure that there was strategic planning on a regional basis to deliver additional medium secure capacity in a co-ordinated way and to ensure that commissioning delivered good value for money. As at January 2006 when the review took place, there were 29 national health service medium secure units providing around 1,972 beds, with a further 1,500 beds provided by the independent sector. This has now increased and there are 32 NHS medium secure units.

The capacity review set out three projections for increases in medium secure capacity, based on variations in trends. The low projections were the lowest capacity increase likely and the high projections were the highest capacity increase likely. The medium projections were the most likely and, in subsequent discussions with stakeholders, the medium projections were thought to be reasonable. An extract from the review with a breakdown of capacity and projections by catchment areas is shown in the following tables. In total, the medium projections in the capacity review predicted an increase in capacity of 614 beds for men and 85 beds for women between 2005-06 and 2010-11, so a total of 699 beds. The NHS is on course to exceed this projected increase in capacity in medium secure services, as long as outlined local plans are followed.

The NHS have been working on local commissioning plans to ensure strategic planning on a regional basis. These local commissioning plans are under constant review by local commissioners and are updated to take account of changing local circumstances.

Extract from the capacity review showing estimated projected capacity requirements for medium secure services:

The following tables show total patient and bed numbers for 2005-06 to 2010-11 broken down by catchment group.

Male patients

2005-06

End 2010-11

Catchment group

Baseline

Lower

Middle

Higher

East Midlands and South Yorks

166

197

223

311

Eastern

211

214

235

293

London

727

828

906

1,155

North West

319

357

391

504

Northern

95

107

120

159

South

265

358

385

466

Wales

145

176

193

247

West Midlands

240

264

302

429

Yorkshire

158

180

185

203

Total—males

2,326

2,681

2,940

3,769

Female patients

2005-06

End 2010-11

Catchment group

Baseline

Lower

Middle

Higher

East Midlands and South Yorks

26

30

33

46

Eastern

48

53

53

55

London

94

116

122

137

North West

64

66

69

79

Northern

11

12

13

16

South

78

98

106

128

Wales

45

44

47

57

West Midlands

60

63

67

79

Yorkshire

29

28

30

32

Total—females

455

511

540

628