One in four NHS mental health inpatient beds are being outsourced to private providers and charities, according to analysis conducted by The King’s Fund.
This was leaving the NHS and patients at risk of higher costs, longer hospital stays and subject to less transparent oversight, the charity warned.
The researchers concluded that use of independent sector beds had gone far beyond acting as valuable surge capacity and instead had become a core part of mental health provision in England.
While, independent sector inpatient beds purchased by the NHS are still free at the point of use for patients, the research showed the scale and type of NHS mental healthcare the public is 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 showed that from January to March 2025, NHS trusts reported almost 18,000 available mental health beds, 89.5% of which were occupied.
However, 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 research also explored the types of mental health care that the independent sector provides for NHS patients.
It found that independent providers were 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.
Transparency concerns
King’s Fund researchers argued this raised concerns about transparency, as the independent sector is not subject to the same level of data collection as NHS providers.
They warned 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.
They add there were several factors that may be driving the lack of NHS mental health bed capacity.
This included many years of low capital investment in mental health buildings and equipment, as well as insufficient support in the community to keep people well.
‘Risk of higher costs and longer stays’
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.”
Anandaciva argued that for the NHS to be sustainable in the long term, there needed to be far more focus on providing care in the community that kept people well.
“Traditionally, the mental health sector has made great progress in delivering community-based care,” Anandaciva continued.
“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.”