Agenda item

The report provides an update on the work of Kent and Medway NHS and Social Care Partnership Trust (KMPT).

Discussion

The Deputy Chief Operating Officer of Kent and Medway NHS and Social Care Partnership Trust introduced the report to provide the Committee with an update on current activities and priorities. Community Street Triage had now been operating for six months. The service was currently provided on Wednesdays, Thursdays and Fridays between the hours of 11:30am and midnight. There had been 112 referrals to the service in its first 4 months which was an average of two per day. Half of the people seen were previously known to mental health services. A review of the service would be undertaken in January or February 2018 once six months of operational data was available. It was noted that the service had diverted 89% of referrals to alternative services thus avoiding the need for section 136 detentions.

The Liaison Psychiatry service provided at Medway hospital was commissioned to provide a 24 hour service. An extended service was launched in October 2017 with there now being two practitioners available on each shift. The percentage of patients seen within two hours of referral had increased from just under 60% in April 2017 to 91% in October 2017. The number not seen in an hour had been 110 in April compared to 44 in October. It was acknowledged that Accident and Emergency was often not a suitable environment for people with mental health challenges. KMPT was working with Medway Foundation Trust and commissioners to create an acute care lounge for use by patients who had mental health difficulties. It was hoped that the existence of the lounge may also prevent people from having to be admitted to an acute care bed.

A Member asked whether the Ruby Ward, which accommodated female patients at Medway Maritime Hospital, was effective and what provision was available for older male patients. The Deputy Chief Operating Officer advised that the Orchards 16 bed ward was available for older adults in Medway and that the 16 bed Jasmin ward was located in Dartford. Ruby Ward had previously been mixed sex but this had changed due to the ward layout. Feedback from female patients suggested that they preferred it to be a single sex ward.

A Committee Member expressed concern that the Street Triage service did not operate on Saturday nights. The Committee was informed that the data analysed prior to commencement of the service suggested that Wednesday,  Thursday and Friday were the three days when there would be the largest demand for the service. This would be looked at again as part of the review to be undertaken in January or February 2018. It was agreed that the outcome of this review would be included in the next update to be presented to the Committee.

In response to a Member question, it was confirmed that the figures provided regarding waiting times for the liaison psychiatry service were unlikely to include patients who left the hospital before being seen. This would be confirmed following the Committee meeting.

One year previously, KMPT had been sending 15 to 17 people to acute beds outside Kent and Medway each week. By September 2017, no patients were being sent outside Kent and Medway following an acute psychiatric presentation.

A Committee Member was pleased that Street Triage provision was in place. However, she was concerned that vulnerable adults were sometimes housed in an unsuitable environment that could hamper their recovery and questioned what was being done to address this. In response to Member concern that the number of people accessing the Street Triage service was very small, the Deputy Chief Operating Officer agreed that it was a small number but noted that the provision was having wider benefits through community engagement.

The Director of Children and Adults Services advised that patients detained under section 136 of the Mental Health Act were no longer being housed in police custody. It was anticipated that there would be sufficient capacity due to use of the Section 136 detention suite. It was also anticipated that the proposed mental health lounge at the hospital would help to reduce the need for patients to be detained.

A Committee Member commented that they were particularly impressed by the community mental health service for older people being provided at Elizabeth House.

Decision

The Committee noted the content of the report, provided comments and agreed that further update should be considered by the Committee in June 2018.