12 December 2025

Hundreds of mental health patients are still sent far from home despite national ambitions to end this practice. But some trusts are proving it can be done, and CNWL is at the forefront.

Back in 2016, the government set a target to eliminate out-of-area placements for adults in acute mental health care. Fast forward to 2024, and nearly 400 patients are still placed outside their local areas. The impact is clear: being far from home often means poorer outcomes and broken trust in the system.

So, how did we change this? At a recent Transformation Partners in Health and Care event, featured in the Health Service Journal, CNWL shared our approach - which is one worth learning from.

Graeme Caul, CNWL’s Chief Operating Officer, summed it up: “understand the issue before coming up with a solution.”

CNWL dug deep into our data, spotting seasonal demand peaks and planning ahead. Teams refined how placements were recorded, distinguishing between genuine out-of-area moves and commissioned pathways. This clarity allowed for better forecasting.

We didn’t rely on a single fix. Opening a new ward in Brent, strengthening community models, and introducing crisis alternatives like the Mental Health Crisis Assessment Service.

From discharge planning to housing support, CNWL embedded a culture where patient flow is a shared responsibility. A 24/7 central flow team and daily director-led calls keep the system moving, while weekly whole-system reviews tackle bottlenecks before they escalate.

CNWL worked hand-in-hand with local authorities, GPs and the voluntary sector. Plus, we listened to patients and carers, ensuring pathways don’t just reflect clinical needs.

The result? Two years without a single out-of-area placement. In a pressured system, that’s remarkable.

Read more: