Agenda item

The aim of this report is to describe in high-level terms our patients’ in-patient journey from, admission to treatment and discharge from in-patient care to an alternative setting. This report seeks to highlight the current processes, challenges and the on-going improvement work which will deliver cohesive, patient centered mental health care to the people of Kent & Medway.

In addition, an overview of safeguarding activity at KMPT has been included in this report.

Discussion:

The Director of Partnerships and Transformation from the Kent & Medway NHS & Social Care Partnership Trust (KMPT) introduced the report which detailed the in-patient journey from admission to treatment and discharge to alternative settings. It highlighted the current processes, challenges and on-going improvement work. It also included an overview of safeguarding activity at KMPT.

Members then raised a number of questions and comments, which included:

·      Communication – in response to a question about how the information relating to the improvements would be disseminated across the wider workforce, the KMPT representatives confirmed engagement would take place across the Trust and partner organisations, as well as the Community and Voluntary Sector to map out the complexity of support available. In addition, the Assistant Director, Adult Social Care, confirmed that from a social care perspective work was also starting in terms of the communications to ensure referrals are made to the right place.

·      Patient voice – in response to a question regarding how patients and carers were listened to, the KMPT representatives explained that there was a real focus on community engagement and a commitment to co-production of services.  In addition, there had been investment into making services more friendly with an enhanced therapeutic support offer.

·      Discharges – in response to a question about the timeliness of discharges and whether these were happening too early for patients, the KMPT representatives explained that the focus was on making sure a patient’s time in hospital was being spent with the most effective care and that the right support was lined up for patients at the point of discharge to support their continued recovery.

·       Out of area placements – in response to a number of questions regarding out of area placements, KMPT representatives explained that these predominantly related to females due to there being a lack of inpatient ICU beds within the Trust and therefore work was carried out with providers to secure provision, often elsewhere in Kent, such as in Sevenoaks. It was also confirmed that there were no patients out of area because of a lack of beds as of that day, but when patients were placed out of area due to capacity, rather than because of a specialist need, work was done to get those patents relocated back in area as soon as possible. 

·      Impact of universities located in Medway – it was asked whether the universities located in Medway resulted in a higher demand amongst university students and whether this added pressure to the system.  The KMPT representatives explained that this did not increase demand on in-patient facilities as this age group were more likely to require community services and added that universities often provided students with mental health support directly.

·      Kent & Medway Listens – reference was made to an engagement exercise undertaken by the Community and Voluntary Sector called Kent and Medway Listens and whether responses to that had been taken account of when redesigning services.  The representatives present confirmed that they had worked closely with Healthwatch and the Health and Care Partnership but were uncertain about this specifically and undertook to report back on this.

·      Recruitment – in response to a question about recruitment challenges, particularly for older adult services, officers explained that this was multi-factorial in relation to location, skill sets and facilities that the Trust had, which would be improving with a new ward opening in the near future.

·      Care home in Wigmore – in response to a question about the progress with this new home, it was explained this 73 bed nursing home was due to open in the next few weeks and commissioners had visited the home and discussed the provider’s plans for the care home with them.

·      Autism – reference was made to a possible scheme for those with autism or similar neurological conditions, where they could register themselves for support to assist them with early intervention to avoid going into crisis.  KMPT representatives confirmed that the nature of in-patient services was not helpful for those who were neurodiverse so work was ongoing to ensure community services were holistic and joined up to prevent the need for in-patient services. They undertook to find out more and report back.

·      Ethnicity – reference was made to the data relating to ethnicity, particularly the percentage of black patients accessing in-patient mental health services.  The KMPT representatives explained that there were a combination of factors, including the fact that Medway had a higher proportion of Black and Asian people than the rest of Kent and that KMPT was good at capturing this data. Plus, those from black ethnicity were at an increased risk of developing mental health issues.

·      Crisis house and safe haven – in response to a request for an update on these settings, the KMPT representatives explained that the co-located safe haven at Medway Maritime Hospital was working well and they would report back on the Crisis House.  In addition, the Assistant Director, Adult Social Care, explained that options were also being considered in terms of the use of 147 Nelson Road, which currently only operated during the day.

Decision:

The Committee noted the report.