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

Helen Greatorex, the Chief Executive of Kent and Medway NHS and Social Care Partnership (KMPT) introduced the report. Members were advised that in March2016, a total of 76 inpatient mental health patients had needed to be placed in beds outside Kent and Medway. This number had fallen to 49 in June and was expected to reduce to 15 by November. It was important to ensure that patients were discharged to the care of an appropriate person to ensure that their support needs were met. This could be a GP, nurse or KMPT staff member. KMPT felt that the commitment made by local authorities had been excellent. The challenges faced were recognised and strong partnership working was taking place to address these.

In relation to the street triage service, which involved Police and mental health nurses working together to ensure swift access to mental health services, this was considered to be a good model. An inter-agency mental health workshop had been arranged to take place on October 12 in Medway, following a request made by the Medway Health and Wellbeing Board. This would involve all relevant partners.

A Member raised concerns that Kent Police were using Section 136 assessments under the Mental Health Act 1983 too frequently and suggested that more mental health resources and better care in the community was needed in Medway. Section 136 allowed the Police to remove a person to a place of a safety where there were concerns for their wellbeing for mental health reasons. It was noted that Kent Police made more use of the powers than other similar forces and that around 25% of street triage by Kent Police was undertaken in Medway. The Director of Children and Adult Services said that integrating pathways effectively was a challenge and that close working was being undertaken between the Council, the Health and Wellbeing Board and KMPT to ensure that funding was used effectively.

A number of questions were raised by a Committee Member. These related to:

·         use of street triage and whether it would be sustainable given that two successful pilots had previously been ended.

·         difficulties caused by ICT.

·         the possible establishment of a recovery house in Medway as addiction was a more significant problem in Medway than elsewhere in Kent.

·         that investment was required in prevention of mental health issues and in helping those affected to recover.

In response, the Chief Executive of KMPT advised that street triage would continue to be used and that the new Kent and Medway Police and Crime Commissioner had made mental health his biggest priority. Regular service user reviews were taking place in relation to pathways of care. 30% of mental health beds were currently occupied by persons with a personality disorder. It was acknowledged that, ideally they would not be admitted to hospital, but suitable alternative provision needed to be in place if this was to be avoided. Investment in prevention was considered to be money well spent. This was an area that was under investigation, especially with regard to recruitment and the commissioning of training. Recovery houses were considered to be a good model.

Another Member highlighted the importance of partnership working and agreed with previous comments that pressure on beds was due to patients filling them who should not be in hospital, such as those with personality disorders.

With regard to a Member question about recruitment at Little Brook Hospital and delays to transfer of care, the Chief Executive agreed that recruitment was a challenge. Only one regular nurse had been recruited so far. Where a patient was unable to be discharged to their home, it could prove difficult for alternative arrangements to be made. The staffing model was felt to contribute to difficulties.

The need for a common sense approach to mental health provision was highlighted by another Member of the Committee. They felt that there was a need to look at the health and voluntary sector in order to improve the support on offer. Ms Greatorex highlighted the availability of a mental health helpline in Medway that had been launched in April, which would help to improve support in the community.

Decision:

The Committee:

a)    Noted the content of the report.

b)    Supported the ongoing work outlined in Appendix 1 to the report and agreed that a report on progress be submitted to the next meeting of the Committee.

c)    Noted the decision of Medway’s Health and Wellbeing Board to explore the scope for an integrated approach toward mental health and that a workshop event had been arranged to take place on 12 October 2016.