Agenda item

Discussion:

The Interim Director of Operations, Kent and Medway NHS and Social Care Partnership Trust (KMPT) introduced a report which set out the response from Kent and Medway NHS Social Care Partnership Trust in respect of the request for regular updates on the position with the acute mental health inpatient beds review. In particular the Committee was updated on progress in enhancing community based mental health services and the impact this was having on reducing the use of acute inpatient beds.  Reference was made to a new therapeutic hostel in Medway and the success of a new Crisis Café.

The Interim Director responded to members‘ questions as follows:

95% Occupancy Rate -  in response to a question about how much importance the Interim Director attached to the 95% occupancy rate, the Interim Director replied that it was a useful measure but bed availability and providing the right service were the most important issues. A supplementary question expressed some concern that this was a different answer to that given at previous meetings.

Value for money - a Member commented that it was apparent not enough beds had been commissioned and the significant amounts being spent on out of area beds (up to £2m) called into question the Trust’s business case given that the Committee had previously been told that lack of finance was the reason why extra beds could not be provided in Medway. A member asked what the business case was for commissioning external beds and how many were needed for clinical reasons as opposed to a lack of availability. Dr Green commented that the focus should be on providing proper care not the number of beds. He accepted out of area beds were expensive but suggested that overall it provided some economies, as permanent extra beds in Medway were not needed. He added that external bed use was now much lower and there was evidence the strategy was working. The Interim Director also felt that the provision of appropriate services was more important than the number of beds per se.

Comparative information - a member asked if comparative information on the provision of mental health beds was available. An undertaking was given to send members a link to a website which allowed mental health services to be compared.

Crisis Plans - in response to a comment about the importance of people being quickly readmitted when another crisis arose, the Interim Director replied that improvements had been made in ensuring that patients had an effective crisis plan. In addition, services were being developed to allow a crisis response team to respond to crisis referrals within one hour.

Complaints and patient engagement – In response to a question if the Trust felt there were still too many complaints, both the Interim Director and Dr Green replied that complaints were encouraged as a means of improving services. Conferences for service users and carers were being used by KMPT as a mechanism for feedback. The Healthwatch Medway representative commented that recent KMPT stakeholder events and carer engagement work had been good.

Transport – Whilst noting recent action taken by KMPT in relation to transport for patients, their families, carers and visitors Members were concerned that the issues relating to transport raised in 2013 at the Joint Health Overview and Scrutiny Committee with Kent and in Medway’s referral to the Secretary of State for Health did not seem to be being addressed in any systematic way. The Committee asked for assurances that families of service users placed in out of area beds were being reimbursed for their transport costs when visiting relatives as these costs could be significant. Reference was also made to negative feedback about the appearance of the bus provided for use by relatives and carers locally.

Primary Care mental health service – the Committee welcomed this pilot in Rochester and Strood but questioned the capacity of only three CPNs to cope with demand.

Decision:

The Committee agreed

a)    to note the report and to request that future update reports should provide a breakdown between use of out of area beds for clinical reasons as compared with their use due to a shortage of beds in Medway and

b)    to recommend the Cabinet, under the item later on the agenda relating to 2015/16 revenue and capital budgets, to reinstate 2 WTE posts in the Mental Health Social Work Team.