In Cambridgeshire and Peterborough, nationally monitored indicators suggest there are particular pressures on inpatient services. There are likely to be a range of factors contributing to this, such as workforce pressures which led to the closure of the Mulberry Ward 3. Greater acuity of mental health need at the point of admission and delays to discharge may also contribute.
Table 3: Nationally monitored indicators for the effectiveness of adult acute mental health pathways. Based on NHS England interpretations
| Measure | Local picture | Interpretation |
| Number of inappropriate out of area placements (OAPs) | There was a 20-times increase in the number of OAPs from April 2022 to 2023. The number of inappropriate OAPs is starting to decline as of Summer 2023. | This is likely to reflect pressures on the acute mental health pathway, with around half of this increase being due to a ward closure (which happened due to workforce pressures). Other contributing factors may be increasing complexity of mental health need, resulting in longer stays, and delayed discharges. |
| % admissions involving people not known to mental health services | Around 7% of people admitted from August 2022 – July 2023 had not been in contact with core community mental health services within the period 6 months prior to admission. This is comparable to other areas in the East of England. | It is a positive sign that people are known to mental health services before admission, as this may reflect that their needs were already being recognised by services. |
| Number of mental health related Accident and Emergency (A&E) attendances | Mental health related A&E attendances are at a similar rate in Cambridgeshire and Peterborough to other areas in the East of England, but attendances due to self-harm are higher than other areas. | It is difficult to interpret higher rates of self-harm attendance compared to other areas, as this may be due to differences in coding and as Addenbrooke’s is a regional trauma centre. |
| % of mental health related A&E waits lasting 12+ hours | From August 2022 to July 2023, 17% of people attending A&E due to mental health reasons spent over 12 hours in A&E. This is higher than most other areas in the East of England. | Long waits in A&E may reflect difficulties accessing assessment under the Mental Health Act and/or inpatient mental health provision. |
| % of admissions involving detention under the Mental Health Act | The number of new monthly admissions where the person is detained under the MHA in the 24 hours pre-admissions or post-admissions shows a relatively stable trend. | Many factors can contribute to detention status, including acuity of mental health need and uptake of voluntary admission. |
| % of available adult acute beds that are occupied at any one time | In June 2023, 91% of adult acute beds were occupied. This is above recommended occupancy levels (85%) but similar to national occupancy rates for psychiatric beds (90.5%). | This indicates significant pressures on inpatient services. |
| Occupied adult bed days per 100,000 weighted mental health population | From August 2022 to July 2023, the rate of admissions to acute inpatient mental healthcare per 100,000 of the population was lowest in Cambridgeshire and Peterborough, compared to other areas in the East of England. | This could be a positive measure, as it suggests that Cambridgeshire and Peterborough is not over-reliant on inpatient care compared to other areas. However, it may also reflect problems with flow into inpatient beds. |
| Average acute mental health length of hospital stay and rate of admissions per 100,000 weighted population lasting 60+ days | From August 2022 to July 2023, the mean length of stay for discharged hospital spells in Cambridgeshire and Peterborough higher than the East of England average. Cambridgeshire and Peterborough ranked highest for the proportion of discharged hospital spells lasting over 60 days (26%) and 90 days (15%). | Contributing factors to increasing lengths of stays over 60 days may include a greater use of out of area placements, greater acuity of mental health need at the point of admission, staffing pressures and delays to discharge. |
| % of 72 hour follow-ups completed for people leaving acute inpatient care | In Cambridgeshire and Peterborough, 60% of discharges were followed up within 72 hours in July 2023. The national target is that 80% of adults are followed up within this stime period, but this target has not been met nationally since data became available in June 2020. | Like other areas, Cambridgeshire and Peterborough is not meeting the national target for timely follow ups following discharge. |