Agenda item

The attached report provides an update on the work of Kent and Medway NHS and Social Care Partnership Trust (KMPT). The report outlines current activities and priorities, successes, challenges and opportunities and provides a reminder of the current service provision in Medway.

Discussion

The Chief Executive of Kent and Medway NHS Partnership Trust (KMPT) introduced the report.There had been significant achievements over the last six to seven months, with it being anticipated that Medway NHS Clinical Commissioning Group would agree funding, at a meeting due to take place on February 4, for Street Triage provision in Medway. KMPT now had a mental health nurse based in the South East Coast Ambulance Service control room at peak times. This had resulted in six avoidances of attendance at Accident and Emergency, nine ambulances not needing to be dispatched and up to five uses of Section 136 powers being avoided. KMPT had recently been inspected by the Care Quality Commission, with 85 inspectors having visited during a week.

In response to a Member question that asked whether vacancies were being successfully filled and how quickly mental health patients should be seen in hospital, the Chief Executive advised that this was challenging at local and national level, particularly the recruitment of mental health nurses. In Medway, instead of relying exclusively on nurses, there were now a range of professionals working on mental health wards to help alleviate the pressure. These included occupational therapists, social workers, psychology graduates and social workers. Such steps had not been taken elsewhere in the country. There was a national target of four hours for a mental health patient to be seen in an Accident and Emergency Department. Medway was the only hospital in Kent and Medway that currently had a 24 hour mental health service. However, having only one such nurse on duty overnight was insufficient, with a bid being made for national funding to address this. Currently, extra staff could be called in from a Crisis Response Centre in order to ensure that the four hour target was met.

A Member asked what would happen in the event that the CCG did not agree funding for Street Triage Provision, particularly in view of the fact that funding for the Personality Disorder Service had previously been considered to be secure. The Member also asked whether the increase in mental health related admissions over Christmas 2016 had been due to admission of patients who had previously accessed the service. In response, the Chief Executive of KMPT advised that there had been a national increase in mental health emergency admissions over Christmas and that analysis was being undertaken to establish why a number of new patients had been admitted. Street Triage provision was considered to be essential and so the CCG would be asked to reconsider its decision if it decided not to award funding. Other possible sources of funding would be identified. There was now closer working between health bodies due to the development of Sustainability and Transformation Plans and it was considered likely that the request for Street Triage funding would be successful. Clinical teams were reorganising care pathways to determine what the best possible model was and how it could be applied across KMPT. The findings would be presented to the KMPT Board in April.

A Member asked whether those patients previously under the care of the specialist personality disorder service, which had been closed, were receiving care in the community, in accordance with the care they had received at the unit. Work was being undertaken to establish what had happened to the people who had previously accessed the Personality Disorder Service. It was acknowledged that services for those with a personality disorder were not good enough.

In response to a Member question, the Chief Executive of KMPT confirmed that there was a good working relationship between the Salvation Army and Street Triage teams.

A Member asked whether plans to provide paramedics, police and street triage teams with access to the same datasets, in order to identify whether a patient was known to services, had been realised. The Chief Executive stated that this was an aspiration but was not yet available, although the nurse based in the SECAmb control centre was able to access common information.

Decision

The Committee noted the contents of the report, provided comments and agreed that a further update should be considered by the Committee in June 2017. It was further agreed that this update should include details of the impact of street triage provision on mental health related hospital admissions.