New Analysis Reveals The Extent Of NHS Reliance On The Independent Sector For Mental Health Care
A significant proportion of routine NHS mental health care is being outsourced to private companies, charities and other independent providers, concludes a new study.
The analysis, conducted by health and care charity The King’s Fund, finds that more than 1 in 4 NHS mental health inpatient beds is being outsourced.
Independent sector inpatient beds purchased by the NHS are still free at the point of use for patients, and there is a long and effective history of NHS services procuring independent sector capacity during periods of high demand and for specialist mental health care.
However, researchers at The King’s Fund conclude that use of independent sector beds has gone far beyond acting as valuable surge capacity and instead has become a core part of mental health provision in England.
The research is the first of its kind to show the scale and type of NHS mental health care that the public are receiving from non-NHS providers. The authors of the study examined data on the number of inpatient beds available for NHS care from independent sector providers of mental health care registered with the Care Quality Commission.
The analysis shows that between January to March 2025, NHS trusts reported almost 18,000 available mental health beds, 89.5% of which were occupied. However, this new analysis finds that in March 2025 there were an additional 7,195 beds available in the independent sector for use by the NHS. This equates to approximately 29% of NHS-funded mental health bed capacity in England being provided by the independent sector.
The increased use of independent sector beds comes with a financial cost and could lead to longer lengths of stay for patients. But the researchers say the NHS has little choice – using the independent sector appears to be the only option when demand outstrips NHS inpatient capacity.
The new research also looks at the types of mental health care that the independent sector provides for NHS patients. It finds that independent providers are providing an increasing proportion of care for people with the most complex needs and who are the most vulnerable, including those with a diagnosis of a personality disorder, and people with learning disabilities and autism.
Researchers at The King’s Fund argue this raises concerns about transparency, as the independent sector is not subject to the same level of data collection as NHS providers. They warn it could leave national and local leaders with less information about patient experience and patient outcomes, including for some people with the most complex needs.
There are several factors that may be driving the lack of NHS mental health bed capacity. This includes many years of low capital investment in mental health buildings and equipment, as well as insufficient support in the community to keep people well.
Siva Anandaciva, Director of Policy at The King’s Fund, said:
‘Independent sector health care capacity acts as an important release valve for many NHS services when they face periods of high demand. It would make no sense to leave private beds empty when the NHS could purchase spare capacity and patients still receive care free at the point of use.”
‘However, our analysis reveals that there has been a significant increase in the share of NHS mental health inpatient care being outsourced to independent providers. Far beyond acting as valuable surge capacity, the NHS has become reliant on the independent sector for delivery of routine mental health care. This exposes the health service to greater risk of higher costs, could leave patients facing longer stays in hospital, and means the public has less transparent data about the quality of services.”
‘For the NHS to be sustainable in the long term, there needs to be far more focus on providing care in the community that keeps people well. Traditionally, the mental health sector has made great progress in delivering community-based care. However, some patients with greater or more complex mental health needs may need inpatient care, and the NHS must do all it can to treat people in the appropriate setting for their health needs.’
