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The closure of long‐stay National Health Service (NHS) hospitals has seen the placement of people with learning disabilities who offend or have offending‐type behaviours placed ‘out of area’ many miles from local services. This move of people out of area has made it difficult in many localities to develop local services and to monitor the quality of care for this group. This paper describes the start of an exercise to examine potential local care pathways for those who present with offending behaviours and to look at differences between the out of area group, and another receiving treatment locally. Within the two groups we found no significant differences regarding rates of psychiatric disorder, quality of life or levels of unmet need. The main difference was that the out of area group was largely characterised by a range of aggressive and challenging behaviour, necessitating the additional structure and securities provided by out of area placements.

This paper describes an ongoing process of engagement with carers of people with intellectual disabilities currently being monitored by an out of area service for both carers of people placed both in area and out of area within a local Mental Health Learning Disabilities team in South London.

Using a series of consultation events, carers were asked to participate in a free dialogue which focussed on everyday issues for carers. This included financial implications of caring, knowledge of care pathways/systems in care, carer's needs and expectations and the support they currently receive.

This paper highlighted a number of issues and concerns that carers face in their daily lives when supporting one or more people. These include lack of recognition, financial difficulties, lack of training and support.

This project offered a valuable insight into current carer perceptions and will help develop further discussion and promote greater engagement by services and mutual understanding with this often neglected group.