Agenda item

This 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 Chairman stated that it was proposed to reduce holding the Trust to account to alternate meetings to endeavour to introduce a more meaningful dialogue.  He also suggested it might be helpful for a representative from the Committee to engage with the Trust and report back to the Committee.

The Director of Transformation, Kent and Medway NHS and Social Care Partnership Trust (KMPT) and Chief Clinical Officer, NHS Medway Clinical Commissioning Group (CCG) stated that the advance notice of questions for the meeting had been very helpful. 

The Director of Transformation, KMPT then explained that the Trust was committed to working closely with NHS Medway CCG, as their commissioners, to deliver a high quality service.  The Chief Clinical Officer, NHS Medway CCG explained that historically the commissioning of acute beds had been undertaken by Kent and Medway PCT but was now being commissioned by NHS Medway CCG and had to be contained within necessary financial constraints.

In relation to the table on page 68 of the agenda he stated that, since the introduction of a new contract with NHS Medway CCG, the risk in relation to out of area placements now rested purely with the CCG.

He discussed the importance of catering for the high number of patients with a personality disorder and referred to the success of the new unit in Medway.  Reference was also made to the high number of section 136 detentions in Medway but research showed that 80% of people, who would normally have been admitted to hospital, could be de-escalated in 48 hours.  These detentions had a significant impact on the Crisis Resolution Home Treatment Team who were spending 4 hours per patient assessing such cases which meant they were prevented from undertaking their main role in supporting people at home.

In response to questions,( some of which he had received prior notice of) he stated the following:

The high level of section 136 detentions in Medway and availability of beds for both sectioned and voluntary admissions

·         Training was being undertaken with the Police to provide education in an attempt to reduce the number of section 136 detentions

·         The crisis pathway hostel, which was available 5 days and 4 nights a week, had reduced attendance at Accident and Emergency by 80%

Cost of new build of an 18 bedded ward

·         The cost of building an 18 bedded ward to the required standard would be £6m and the operating/running costs would be £1.5m a year to provide the right therapeutic care and the required level of staffing

·         KMPT could only ever supply what they are commissioned by the CCG to provide

Out of area bed usage

·         If a bed was not available locally KMPT would attempt to find the nearest available bed but this could sometimes mean it was a long way from Medway.  KMPT would then attempt to repatriate the person as soon as possible to Medway

Action taken in response to the notice to improve issued by the Health and Safety Executive

·         Improvements had been put in place since the notice to improve had been issued by the Health and Safety Executive, due to out of date safety procedures, and it was hoped this could be remedied shortly

Use, and availability of, the patient transport bus

·         In relation to patient transport it was stated that this was provided if requested.  The bus KMPT previously used was no longer available as it had only been used by four people in six months.  It was made clear that free car parking was available at the various sites

Invites to Committee Members to stakeholder meetings

·         In the event of further stakeholder meetings, contact would be made by KMPT with Democratic Services to invite Members of this Committee to attend

Further details in relation to the new mental health decision unit were requested.  This would be made available in a briefing note along with an update on the street triage scheme and section 136 detentions.

A number of members of the Committee expressed concern at the proposal made earlier in the meeting that KMPT be invited to attend alternate meetings particularly as Members considered that there were some important ongoing issues which needed to be kept under review.  The view was also put forward that, particularly for the benefit of new Members of the Committee, it was important to continue with scrutiny at each meeting.

It was then proposed that, in addition to reducing attendance by KMPT at Committee to alternate meetings, that a cross party discussion should take place to discuss the possibility of adopting a different approach to scrutiny of KMPT. 

Decision:

The Committee agreed that:

(a)  With immediate effect KMPT should be invited only to alternate meetings of the Committee; and

(b)  A cross-party meeting be arranged to enable Members to discuss a different approach to scrutinising KMPT.