Agenda item

This paper has been provided to update HASC of the discussions that have been had to date and the proposed next steps for the service provided at the Frank Lloyd unit.

The Frank Lloyd Unit is a Continuing Health Care unit located on the Sittingbourne Memorial Hospital site. Kent and Medway Partnership Trust (KMPT) is commissioned by Kent & Medway CCGS to provide this service. The unit provides highly specialist care and treatment for patients at a very advanced stage of their dementia, who have a range of complex needs including behaviours that challenge.

Discussion

The number of patients accommodated at the Frank Lloyd Unit had reduced over the last few years due to changing national practice in relation to continuing care. It catered for patients with acute dementia and particularly challenging behaviour. The Unit had 15 beds but by 2018, the number of patients had reduced to 7. There had been a discussion with the Kent and Medway NHS and Social Care Partnership Trust about the viability of the Unit and there was an assumption that it would close in March 2020. This would depend on the 4 remaining patients having been found alternative accommodation by then and it was therefore possible that the Unit may remain open for longer.

Following discussion with NHS England, commissioners considered the proposal amounted to a substantial variation to the health service with it having been agreed that full public engagement / consultation would be undertaken ahead of the unit closing. The planned NHS Gateway Review of the proposals had been delayed as further detailed work was required in relation to care pathways and future demand. Public engagement / consultation would not commence until this work had been completed. Consideration was being given to undertaking this consultation in tandem with consultation on separate proposals relating to the St Martin’s Hospital site in Canterbury.

The following issues were discussed:

Transfer of patients and future demand – A Committee Member asked how the transfer had gone of the patients moved from the Unit to date and whether there was confidence that services would be able to meet increased and more complex demands in the future. The Deputy Managing Director of NHS West Kent Clinical Commissioning Group said that national guidance stated that as many patients as possible should be supported to live in their own homes or community settings. However, it was acknowledged that commissioners needed to gain a better understanding of future demand for services and it was recognised that there were a small number of patients who might continue to need hospital inpatient care. No patient level data was currently held but Continuing Care teams had been asked to provide summaries of the outcomes of patients who had been located away from the Frank Lloyd Unit to date. Further information on this and future demand would be provided to the Committee when available. There was also a need to understand local care home markets and capacity of homes to care for patients with varying degrees of dementia.

Current capacity and future demand – There had been no new referrals to the Unit for a year. The Deputy Managing Director was in the process of clarifying where patients were now going. Work was being undertaken to ascertain likely future demand for the type of inpatient facility provided by the Frank Lloyd Unit. It was anticipated that this would take one to two months to complete and public engagement / consultation would not commence until commissioners had all the information required.

Provision of facilities – A Member highlighted the need to provide facilities that were able to continue caring for patients as their condition worsened rather than the patient having to move.

Further information - Some Members felt that further information was required to enable the Committee to consider whether the proposals amounted to a substantial variation.

Decision

The Committee:

i)     Considered and commented on the report and proposed development or variation to the health service.

ii)    Requested that further information be presented to a future meeting of the Committee to enable it to determine whether it considered that the proposals amounted to a substantial development of or variation to the health service in Medway.