Background: There is an increase in people with learning disabilities with offending and other disturbed behaviour who are placed in the local community and out of their area of origin. Aims: To compare clients placed locally and out of area. Method: All authorities in an English region were surveyed and interviewed about their clients placed locally and out of area. Results: External placements were common place and expensive especially for clients with complex needs. Information regarding these clients was variable as was the joint commissioning process. The population was predominantly young and male requiring high levels of long term funding. Conclusions: To reduce flows of high cost clients out of area, there is a need to develop joined up commissioning, and monitoring of services and partnerships with local providers to increase capacity and improve quality. Better information would enable commissioning to become less reactive.