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In 2004/2005 local partnership boards requested West Midlands South and Birmingham & The Black Country Strategic Health Authorities (SHAs) to review and report back on the circumstances of adults with a learning disability placed out of area. There are currently 623 known adults with learning disability living out of area at an annual cost to commissioning services of £35 million. In 1993 the Mansell Report predicted major problems and potential consequences relating to future planning of services for people with learning disabilities and complex needs. Twelve years on this has become a reality, as more people are living in highercost services away from their original district and families. There is no evidence from this review that out‐of‐area services are any worse or any better than local services. The review does not set out to make a direct comparison of out‐of‐area placements and services provided locally, nor does it reflect on the number of people being imported into the West Midlands. With lack of monitoring and reviewing of placements, many people have been left solely to the care of provider organisations. Commissioners of services are becoming reliant on the Commission for Social Care Inspection (CSCI) to raise any concerns with them. This review calls for specific action to be taken now to reverse this trend of increasing out‐of‐area placements and to make more cost‐effective local solutions.

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