Background
The National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH) has found that there is a high risk of suicide for people who have been discharged from mental health inpatient care. NCISH’s 2023 Annual Report found that 27% of general population suicides over the last 10 years were identified as patient suicides – people who had been in contact with mental health services within the last 12 months of their life. Ensuring that people are followed up post-discharge is crucial to determining the level of support needed during a mentally and emotionally vulnerable time.
Previously, NHS England published data on the number of patients on the Care Programme Approach followed up within seven days of discharge from psychiatric inpatient care. This publication was paused during the coronavirus (Covid-19) pandemic, and in April 2021, NHS England announced that they would stop publishing this statistic altogether, following a consultation.
In 2019/20, the NHS introduced a national CQUIN indicator to incentivise NHS providers to follow up all adults within 72 hours of discharge from mental health inpatient care either directly into the community or into non-psychiatric inpatient care. The target was brought forward from seven days to 72 hours following evidence from the NCISH which found that there is an increased risk of dying by suicide on days 2 to 3 following discharge from hospital.
Refer to these resources to access information on the legal rights of patients while staying in hospital and what to expect post discharge.
The previous national threshold stated that at least 95% of patients should be followed up within seven days of discharge from psychiatric inpatient care. The target was consistently met until Q2 2019/20 (July to September 2019), when performance dropped to 94.5%. In Q3 2019/20, the proportion of patients followed up within seven days increased slightly to 95.5%.
The seven-day follow-up measure remained the official national standard before the new 72-hour measure replaced it in Q4 2019/20. The new operating standard stated that at least 80% of patients should be followed up within 72 hours of discharge from psychiatric inpatient care. It has not been met at a national level since June 2020, when the data first became available. As of April 2023, only 73% of adults leaving psychiatric inpatient care were followed up within 72 hours; of 5,912 individuals eligible for follow up within 72 hours, 4,309 individuals received the follow up while 1,603 did not.
About this data
The proportion of patients on the Care Programme Approach (CPA) who were followed up within seven days of discharge from psychiatric inpatient care was calculated as:
· The number of patients on CPA who were followed up (either by face-to-face contact or by phone discussion) within seven days after discharge from psychiatric inpatient care during the quarter, divided by the total number of patients on CPA discharged from psychiatric inpatient care during the quarter.
· All patients discharged to their place of residence, care home, residential accommodation, or to non-psychiatric care must be followed up within seven days of discharge. All patients discharged from a psychiatric inpatient ward are regarded as being on CPA. The seven-day period is measured in days, not hours, and starts on the day after the discharge.
For more information, please see the Mental Health Community Teams Activity Return – Data Definitions.
The proportion of patients discharged from mental health inpatient care who were followed up within 72 hours from discharge was calculated as:
· Discharges from adult acute beds followed up within 72 hours in the reporting period, divided by the proportion of discharges from adult acute beds eligible for 72 hour follow up followed up in the reporting period
· Those eligible were defined as having been in an acute bed and discharged, to home or a new ward, in the last three days of the previous month or all but the last three days of this reporting month.
The data only includes CCG-commissioned inpatient beds and does not currently include people discharged from specialised commissioned inpatient mental health services, Health and Justice services or prison settings.