Agenda item

The report sets out the response from Kent and Medway NHS and Social Care Partnership Trust in respect of the request for regular updates on the position with the acute mental health inpatient beds review.

Discussion:

The Interim Director of Operations, Kent and Medway NHS and Social Care Partnership Trust (KMPT) gave an operational update to the Committee and tabled  a presentation in respect of section 136 of the Mental Health Act detentions.

He referred in particular to the increased of the need for out of area acute inpatient beds and the variability of that figure.  Delayed discharges were also impacting on this and he referred to the reasons why the delays were taking place, some because of housing issues, a number waiting for specialist treatment and some for further decisions about their care. 

Members of the Committee expressed their concerns about the inappropriateness from a patient and carer perspective, and high cost, of out of area placements particularly in the light of the decision to close acute inpatient beds in Medway and provide the beds elsewhere. 

As far as section 136 of the Mental Health Act detentions were concerned  he explained what happened when the Police take a member of the public to a place of safety and informed Members about the process that needed to be followed.  He stated that a place of safety could be a hospital (a section 136 suite),or a police station.  An assessment of the person’s mental health state would take place by mental health professionals and the person would then either be detained under a section of the Mental Health Act, admitted informally or they could go home with follow up where appropriate.  He stated that in Kent and Medway only 10-12% of those detained were admitted to hospital.

Measures were now being put in place through the Mental Health Crisis Concordat to enable agencies to work together to reduce the number of section 136 detentions which take place.  Training for the Police was taking place to assist them to deal with people presenting with mental health problems and NHS Medway CCG were facilitating this.  Members referred to the need for mental health problems to be assessed and actioned appropriately particularly bearing in mind the numbers of people in the criminal justice system and in prisons who had  mental health problems.

Concern was expressed at the prospect of the Police not continuing with the street triage service as they considered the scheme was too resource intensive.  The Interim Director of Operations, KMPT explained that alternative plans were being considered.

The Chief Clinical Officer, NHS Medway CCG stated that the Health and Wellbeing Board had recently considered the Mental Health Crisis Concordat and signed up to its aims, but agreed that there was more to be done to ensure all parties worked together to achieve the best outcome.  Lessons could be learned from successes in other parts of the country.

Reference was made to recent Board meetings of Kent and Medway NHS and Social Care Partnership Trust and NHS Medway CCG where the high cost of out of area placements was mentioned in terms of risk to the financial viability of KMPT and the point made that the cost of out of area placements over a year was similar to that estimated for the provision of an 18 bed unit.  It was felt that the money could have been better spent to provide acute inpatient beds in Medway rather than having to bear the recurring cost of out of area placements.

The Interim Director of Operations, KMPT stated that he did not disagree that there were currently too many people going out of area for inpatient beds but agreed to talk to the Committee at a future date about the plans in Medway to avoid hospital admissions.

In response to a Member concern about what was happening today for people needing appropriate care, the Chief Clinical Officer, NHS Medway CCG  stated that consideration had to be given to value for money but assured the Committee that all people requiring treatment were receiving that assistance, albeit sometimes outside of Medway.

A question was asked about the proportion of costs shared between KMPT and NHS Medway CCG in relation to out of area beds and a request made that further details on this should be available to the Committee as soon as possible.

Decision:

(a)  A report be submitted to the Committee, as soon as possible, about the shared cost of out of area placements to both KMPT and NHS Medway CCG;

(b)  The report was noted.