Out of Area Placements (OAPs) quick guide to submitting data

There is currently only a nationally agreed definition for what constitutes an adult acute care Out of Area Placement (OAP). As part of the quality framework, integrated care boards (ICBs) have been tasked with identifying out of area placements across all mental health bed types and the national team will be working with the system to support them to localise and realign inpatient care

The focus of national reporting is on adult acute OAPs for patients placed in the relevant bed types (adult acute, older adult and PICU). However, providers can apply local definitions to collect and submit OAPs for any Mental Health Services Dataset (MHSDS) bed type and activity is reported for placements to the full range of MHSDS bed types. 

Adult acute OAPs

An adult acute OAP occurs when a person with assessed acute mental health needs who requires adult mental health acute inpatient care, is admitted to a unit that does not form part of the usual local network of services. By this, we mean an inpatient unit that does not usually admit people living in the catchment of the person’s local community mental health service and where the person cannot be visited regularly by their care co-ordinator to ensure continuity of care and effective discharge planning.

Sending providers are to determine if a placement is classed as an adult acute OAP. The definition necessarily allows providers to apply knowledge of local catchment arrangements and the person’s circumstances when deciding if a placement is an OAP. OAPs can occur within one NHS provider, in other NHS providers, or independent sector providers (ISPs).

Fuller guidance on the definition and continuity principles for an adult acute OAP is available via the FutureNHS platform (requires login).

This table includes the OAPs measures that are published as part of the Mental Health Monthly Statistics publication, including those focused on inappropriate adult acute OAPs.

Data should be recorded by both the sending and receiving provider unlike the now retired interim Clinical Audit Platform (CAP) collection where only sending provider information was used.

Most OAPs activity metrics are reported using data from the receiving provider but data from both providers is used to triangulate the data recorded in the MHSDS to provide an overall picture of the person’s care. The following sections highlight the MHSDS data items that are specific to measuring and monitoring OAPs.

The table below lists all the MHSDS fields needed to accurately report on OAPs, alongside the mandatory tables and data items needed to make a submission to the MHSDS. More information can be found in the MHSDS user guidance and Technical Output Specification.

Data needed for recording OAPs as a sending provider

The sending provider is the provider that has taken the decision to place someone outside of the usual local network of services. In addition to mandatory fields in MHSDS, NHS England needs the following information from a sender to identify an OAP has taken place:

The receiving provider is the provider outside of the usual network of services that is providing the person with acute inpatient care. This could be another (or the same) NHS trust or an independent sector provider.

Unlike the interim and now retired (CAP) collection, receiving providers also need to submit information about any OAPs that were active at any point during the month.

To report on OAPs via the MHSDS, the information shown in the table below is needed from a receiver to identify an OAP has taken place and how long for.

The following 3 tables need to be submitted in each submission with their respective mandatory and required fields. More information can be found in the MHSDS user guidance and Technical Output Specification.

* Whilst this is not specific to OAPs, each patient must have a GP code recorded for their records to be accepted into the dataset. Iif you do not know the patient's GP code then the default 'V81997 - No Registered GP Practice', 'V81998 - GP Practice Code not applicable' or 'V81999 - GP Practice Code not known' codes can be used.

For Specialised Commissioning services, NHS England monitors Out of Area Placements via 'Natural Clinical Flows' (NCFs). NCFs define the expanse in which patients from a given geographical area would generally use a particular service or group of services.

NCFs are not catchment areas, that is they do not presuppose boundaries outside of which patients should not be admitted, nor within which only patients from that area should be admitted.

All specialised MHLDA Provider Collaboratives have an agreed NCF. These services include Children and Young People’s Mental Health Services, Adult Low and Medium Secure Services, Adult Eating Disorder Services, and Perinatal Mental Health Mother and Baby Units.

The NCF reference data is held by NHS England and is applied to healthcare providers’ MHSDS submissions, using the Organisation Site Identifier and the Specialised Mental Health Service Category Code.

Access the code used to create the OAPs measures.