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

An Out of Area Placement (OAP) occurs when a person with assessed mental health, learning disability or autism needs is admitted to an inpatient bed outside their 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 or community team to ensure continuity of care and effective discharge planning.

Sending providers and the ICBs commissioning their services are to determine if a placement at another receiving provider is classed as an OAP based on the definitions provided here. The definition 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).

Placements, regardless of provider type, are classed as out of area only where they meet this definition. Where the OAPs definition does not apply the relevant OAP data items should not be completed as the admission is not out of area, but all other relevant inpatient tables and data items must still be submitted.

Fuller guidance on the definition and continuity principles for an adult acute OAP is available via the FutureNHS platform (requires login). These continuity principles apply equally to all bed types included in the expanded scope for OAPs in the following section. The Futures guidance will be updated to reflect the expanded range of bed types it is relevant to.

Specialised MHLDA provider collaboratives operate within agreed Natural Clinical Flows (NCFs), which describe typical geographical patterns of service use without imposing strict boundaries. NHS England specialised commissioning uses NCFs, referring to care delivered “outside of NCF” rather than “Out of Area Placements,” to reflect commissioning across wider regions, with NCF reference data applied to MHSDS submissions.

The scope of the original national definition of acute mental health OAPs,  was adult acute, older adult (functional) acute and psychiatric intensive care unit (PICU) beds. However, the bed types in scope of the national focus on eliminating use of OAPs has increased as set out in the February 2024 Commissioning framework for mental health inpatient services. The national guidance on OAPs will be updated to reflect this expanded scope.

Integrated care boards (ICBs) are required to work with providers to identify out of area placements across all ICB commissioned mental health, learning disability and autism bed types. ICBs and providers should therefore apply this OAP definition across the following bed types:

• 200 - Acute adult mental health care
• 201 - Acute older mental health care (Organic and functional)
• 202 - Adult psychiatric intensive care (Acute mental health care)
• 205 - Adult Mental Health Unit for Adults with a Learning Disability and/or Autism
• 212 - Adult Mental Health Rehabilitation (Mainstream Service)
• 213 - Adult Mental Health Rehabilitation for Adults with a Learning Disability and/or Autism (Specialist Service)
• 209 - Adult Neuro-Psychiatry / Acquired Brain Injury

The OAPs measures that are published as part of the Mental Health Monthly Statistics publication are available within the MHSDS metadata file.

New measures, based on Mental Health Admitted Patient Class codes 205, 212, 213 and 209 as above, will be introduced in 2026-27.

Data should be recorded by both the sending and receiving provider. Whilst most Out of Area Placement (OAP) activity metrics are reported using data submitted by the receiving provider, data from both providers is used to triangulate the information recorded in the MHSDS and to provide an overall picture of the person’s care pathway.

It is therefore important that a sending provider clearly notifies a receiving provider when a person is being placed out of area, including the reason for the OAP, to ensure this information can be recorded accurately and consistently within local systems and submitted correctly to the MHSDS by both the sending and receiving provider. Effective communication between the sending and receiving provider supports data completeness and improves the reliability of OAP reporting and monitoring.

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 inpatient care. This could be another (or the same) NHS trust or an independent sector provider.

Receiving providers 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.

A new lookup table MHS903WardDetails has been introduced in v6.0 of the MHSDS to record the characteristics of and details about the ward where a patient has been treated.

This table includes a number of data items that were previously located in the MHS502WardStay table.

It is expected that each WardCode recorded in the MHS502WardStay table will link to a WardCode recorded in the MHS903WardDetails table.

Where a patient on an OAP referral is initially placed in an adult bed type but then moves to another bed type, the receiving provider should continue to submit activity against that original OAP referral until the patient is discharged from the provider. 

This means that the provider should close the initial ward stay with the adult bed type and open a new ward stay with the new bed type but both ward stays should be linked to the original OAP referral.

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.

Required submission to MHSDS 

Access the code used to create the OAPs measures.