Agenda item

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

Discussion:

The Chairman and Members of the Committee stated that the visit to KMPT services the previous week had been very helpful and informative.

The Executive Director, Operations, Kent and Medway NHS and Social Care Partnership Trust (KMPT) introduced a report on an update on acute mental health inpatient beds and welcomed the Member visit and extended an offer to those Members unable to attend on that date to visit in the future.

He stated that the Trust was subject to contractual negotiations at present with NHS England and the Trust Development Agency and he hoped to be able to report on this further at a future meeting.

He referred to a letter by the Chairman on behalf of the Committee and stated that the Trust would be mindful of the advice in that letter with regards to improving planning and design of new and innovative projects prior to receiving commissioning support in order to be able to demonstrate more efficiently the desired outcomes and whether they were being met.

Reference was made to the increase in numbers of younger adults in Kent and Medway being discharged from acute services which was up to 200 compared to 150 in June.  However, the number of admissions had not gone down.  Some detailed clinical work was currently being undertaken to assess the reason for this on a patient by patient basis. 

Discussion took place about the section 136 detentions and it was stated that the criminal justice diversion service was now being extended to Medway and Swale Police Stations in an attempt to reduce the number of such detentions.  There had been a positive response from the Police about the fact they now had a mental health practitioner to consult for advice at the Police station.

In response to questions the following points were made:

·         It was difficult for the Trust to recruit and retain staff on the basis that the close proximity to London meant that a number of staff were attracted to London because of the enhanced salaries on offer

·         Members stated that since the visit the previous week it was easier to appreciate the challenges facing the Trust and to understand that the prevalence of patients suffering mental ill health, and presenting in A&E in crisis, in Medway was far greater than most areas of Kent

·         Members were encouraged by the multi-agency integrated approach being taken at the hospital where Occupational Therapists, Psychiatrists, Crisis Resolution Home Treatment Team and Psychiatric Liaison staff all worked together

·         Following a question about waiting times it was stated that there was an average 4 week wait for an assessment and 12 week wait for treatment, 90% of patients were seen in 4 weeks and 99% treated in 18 weeks.  Handover of staff between shifts normally took no more than 30 minutes

·         Further to a question about an invitation received by a Member of the Committee to use talking therapies, the Chief Clinical Officer, NHS Medway CCG explained that these were in relation to primary care mental health services rather than acute mental health care supplied by KMPT

·         The talking therapies were aimed at low level mental health problems and seemed to be successful for some people.  Some were referred to such services by their GP others would self refer. The Chief Clinical Officer, NHS Medway CCG confirmed that such organisations would, however, always refer patients back to their GP if they felt their problems were more serious and outside of the scope of talking therapy

·         Concern was expressed by some Members about the numbers of acutely mentally ill patients being held in the Clinical Decision Unit at Medway Maritime hospital awaiting an inpatient bed.  The Executive Director, Operations from KMPT acknowledged that this situation was far from ideal and confirmed that such people were a ‘hidden demand’.  He intended discussing this matter with NHS Medway CCG as the commissioners.

·         It was acknowledged that at the moment the information technology used by the mental health trust was not compatible with the Council’s adult social care information technology.  While Medway Council’s social workers were able to have access to the mental health trust’s database on a ‘read only’ basis they could not offer the same service back to the mental health trust.  Work was ongoing to remedy this situation.

·         In response to a question about the high level of external bed days utilised between April and October 2015 it was stated that no specific reason could be given for this high figure.

·         The single point of access for acute mental health services should be operational by the end of March and would be available to GPs as well as to members of the public, patients and carers.

·         The Deputy Director, Children and Adults informed the Committee that he was involved in some joint work with KMPT around developing an integrated care pathway across mental health and social care and that staff were enthusiastic about the plans

Decision:

The Committee:

(a)  Noted the report; and

(b)  Supported the ongoing work outlined in the report and requested a further update to the first meeting in the new municipal year.