Agenda item

Members are asked to consider a paper regarding proposals for eradicating outdated dormitory accommodation for mental health inpatients in Kent and Medway and constructing a proposed new purpose-built facility.

Discussion:

Members considered a paper regarding proposals for eradicating outdated dormitory accommodation for mental health inpatients in Kent and Medway and constructing a proposed new purpose-built facility.

The Committee was advised that Kent County Council’s Health Overview and Scrutiny Committee had considered these proposals on 10 June 2021 and had decided they were not a substantial variation. Therefore, the matter would not need to be considered by the Joint Health Scrutiny Committee.

Members discussed the following issues:

•       Consultation – in terms of when this would start, Members were advised that a range of dates were being considered with a likely early August start. In response to comments about a lack of progress since the Committee had recommended public consultation in March and what would happen if the outcome was to not accept the closure of Ruby Ward, Members were advised that there had been a lot of work needed with the regulator (NHS England) to get to this stage, including the development of a pre-consultation business case. The CCG were required to commission services across Kent and Medway and recognised that the timetable set by NHS England had caused some problems for Medway Members. The CCG acknowledged this would be a one option consultation, but its purpose was to understand the issues and concerns services users and their families had so that any disadvantages could be mitigated. The CCG stated they were genuinely open minded to any alternative options suggested that met the case for change and could pass the same evaluation criteria as other options considered to date. The CCG confirmed  the responses to the consultation would be independently analysed and would feed into a decision-making business case to be considered by the CCG governing body towards the end of this year. No decision had been made yet and the aim was to hear from those who would be most impacted. As part of the consultation, discussions would take place with groups likely to represent those most affected.

A comment was made that those most likely to need this service would by their nature often find it difficult to discuss the issues.

Medway Healthwatch were involved in the consultation process and had already commented that, as it was a one option consultation, the public should be given the opportunity to add comments and had asked that questions around travel be added.

A comment was made that it would still be difficult for many people to travel the 12 miles to Maidstone by public transport and levels of car ownership for the groups affected by this change were lower.

A point was made that there were high levels of diabetes and heart disease in Medway, and this was likely to lead to increased levels of dementia.

•       Investment in Medway – how much investment would occur in Medway should Ruby ward close was queried. In response, Members were advised that the proposals were about relocating not closing a service and Medway residents would still be able to access this service and all other KMPT services, as well as the wide range of community based services and support close to home described in the previous paper (Transforming mental health and dementia services in Kent and Medway). There was significant investment planned for Kent and Medway in total but as KMPT was contracted to work across both areas there was not a specific budget for Medway, although all services available in Medway could be made available for Members. The point was made that, nevertheless, the public would perceive this change as a service being removed from Medway and this perceived loss could affect people’s confidence they would get the support they needed and be supported by their families. The CCG commented that this issue of perceived loss was important to understand and would be included in the consultation discussions and consideration. In response to the latter, a point was made that the loss was real and not perceived and even if the service was better, there would still be families who would not be able to travel as regularly to visit.  The Director added that she had made it clear to the CCG that Medway needed to receive equal treatment and respected as a discrete geographical area. The CCG emphasised their commitment to Medway and to improving services and that they understood the levels of deprivation in Medway and were looking at potential ways the travel challenges for some visitors could be mitigated as part of the pre-consultation business case.

KMPT advised that the new facility would be mixed sex, but patients would continue – as now - to be placed in a ward according to their needs and Medway residents were able to access other wards in Kent.

•       Users of Ruby Ward – it was argued that, as out in the report to the March meeting, the largest number of users per former CCG area came from Medway and Swale. The CCG responded that the majority of patients in the period analysed were not Medway residents, who represented 30% of the overall numbers. The CCG stated they could look again at how the figures were presented to make this as clear as possible in the consultation document.

Decision:

The Committee agreed to:

a)    note the draft consultation plan.

b)    request that updates be brought to the August and October meetings on the progress and outcome of the consultation before the Committee submitted its response.