Agenda item

This paper provides an update on the ‘Eradicating mental health dormitory wards in Kent and Medway’ programme, including the programme timeline, the integrated impact assessment, implementation planning, the consultation plan and timeline and proposed visits to better understand community-based mental health services in Medway.

Discussion:

Members considered a report on the ‘Eradicating mental health dormitory wards in Kent and Medway’ programme.

The following issues were discussed:

·     Consultation – in response to a comment about the number of unconfirmed activities in the timetable (paragraph 7.4 of the report), Members were advised that this was due to the need to submit the paper before the consultation started. A full list of dates and times would be sent to Members. In response to a point that the draft consultation document should have been submitted to the Committee, Members were advised that the tight timetable had prevented this, but the draft consultation document had been informally shared with Members before the public launch and the feedback received had been incorporated.

·     Proposals and reasons for change – in response to a request for more clarity on the reasons for change, Members were advised that the proposal was to relocate Ruby Ward to a new location on the Maidstone Hospital Site owned by KMPT. The number of beds would increase from 14 to 16. The new site would allow enhancements not possible at the Ruby Ward site, including more space for therapeutic activities, access to outside space and en-suite private rooms. The privacy and dignity of patients would be significantly enhanced, and the environment would be more conducive to support people to get better and be discharged more quickly. Whether KMPT had sufficient staff to achieve these ambitions was queried and KMPT advised that the Trust had secured national funding to improve therapeutic services and recruit gym instructors etc.

A comment was made that the proposal represented the closure of Ruby Ward and, given the highest number of users came from Medway, the new unit should be located in Medway, albeit the new unit would result in a better service. As the new unit would be a mixed sex ward, whether this meant a reduced service for women was queried as well as whether there would be sufficient beds in the future given likely demographic changes. In response, KMPT advised that the number of beds would increase from 14 to 16 beds, so overall the bed base would increase across Kent and Medway. Ruby Ward was female only, but KMPT operated a flexible bed base with admissions on a needs basis.

A point was made that it was disappointing another mental health facility appeared to be moving out of Medway, although it was acknowledged the new facility would be an improvement. There was a need now for patients and families to understand what was happening, a proper transition programme and free or heavily subsidised transport.

·     Location of the new unit – concern was expressed at the possibility of the new unit being located adjacent to a psychiatric ward as this would be detrimental for patients and visitors. KMPT advised that the new unit would be a psychiatric ward for older people and would be located on a site with other psychiatric wards.

·     Ruby Ward staff - questions and concerns were raised about ongoing consultation with staff, what would happen to staff who did not want to relocate to Maidstone, staff welfare, possible changes in terms and conditions and whether this could lead to a shortage of staff at the new unit.  A guarantee was requested that there would be no redundancies. KMPT responded that their preference was to support all Ruby Ward staff to stay with KMPT. KMPT would follow its normal consultation process and support staff to identify their best options. The Trust would facilitate any staff who wanted to relocate as well as those who wished to remain in Medway.  Regarding the latter, KMPT operated a number of services in Medway and other opportunities with NHS partners would be another possible option. Any staff who relocated would be recompensed for extra travelling costs. It was not possible to guarantee a suitable job could be found for everyone who did not wish to relocate but every effort would be made to find a solution which did not entail a reduction in pay. KMPT had an active recruitment programme but there were national shortages in some areas, including Mental Health nurses and the Trust was working with partners to get right skills mix.

·     Transition to new unit – in response to questions about how the transition would be managed, KMPT commented there were well formed plans around decanting patients from wards, which had been successfully followed when Ruby Ward was used for Covid patients. The length of stay in the ward was around 40-60 days and admissions would be planned around that.  The Trust would work with patients and families and staff would be made fully aware of the plans so they could inform patients and families about the process.

·     Transport - in response to comments about the need to minimise disruption and costs involved in travelling to Maidstone, Members were assured that views on this issue would be sought during the consultation. The consultation would involve a series of focus groups, including people in deprived areas, to better understand these issues and identify possible solutions. The travel analysis showed that for some people in more deprived areas there was an adverse impact if using public transport and the CCG were keen to understand how to mitigate that. The point was made that the CCG should not assume the numbers of people needing to be assisted with travel would be very low. The CCG’s aim was to extend current transport provision and add to it whatever suitable ideas emerged from the consultation.

In terms or whether taxis would be offered, Members were advised that KMPT would work with families on an individual basis and if a taxi was the most appropriate form of transport, then it would be chosen.

It was confirmed that there would be no charge for visitors at the new dedicated car park at the Maidstone site.

Decision:

The Committee agreed to:

a)    note the updates on the programme and consultation timelines provided in this report and, as a result, agree that the 12 October meeting of the Committee be moved to either 26 or 28 October.

b)    note the information provided in relation to the integrated

impact assessment, and request that proposals be submitted to the next meeting on how to reduce the impact of increased travel times for patients and visitors.

c)    accept the invitation for a visit during the consultation period.

d)    continue to work with the CCG during the consultation and request that the 1 November date for providing a response and recommendations to the CCG on its consultation on the proposed closure of Ruby Ward be changed to allow time for a response to the proposals to be submitted.