Agenda item

This report seeks to give a broad overview of mental health services provided by KMPT across Medway and the wider county of Kent. The report will focus on KMPT’s six strategic priorities as well as linking these priorities with the wider Public Health, Health & Wellbeing Strategy. At the request of the Board an update is also provided on tobacco dependency and physical health checks for those experiencing serious mental illness (SMI).

Discussion:

The Director of Partnerships and Transformation, Kent and Medway NHS and Social Care Partnership Trust introduced the report which detailed the work undertaken since the new strategy was implemented last year. Following the initiation of the Mental Health Together pilot in Thanet, they were on schedule to launch the community mental health network in Medway, to improve outcomes for patients.

Members of the Board raised some comments and questions which included:

• It was evident that transformation was taking place in the service to address health inequalities, the voluntary sector played a large part in supporting the community and there were concerns that their views were not being adequately taken into consideration.
• There were extreme challenges in adult social care, and it was vital to explore all avenues to build on services for the community to come out of long stay and hospital settings quicker.
• Further thought was needed on how to use our estate to support the work being done.
• Consideration should be given to the actions taken through the GP task group work which may provide ideas for solutions.

In response to a question on what improvement and incentives were being made in recruitment and retention of staff in mental health services which was historically difficult to recruit to, the officer acknowledged the difficulties in recruitment in the sectors but provided assurance that there were several initiatives that took place including overseas recruitment, expansion of social work apprenticeships, and combination roles. There was previously a 20% recruitment gap in Medway which had now fallen to 14%.

It was commented that there were still high numbers of people occupying beds, in acute services who were ready to be discharged but with nowhere to be discharged to. The officer said that some of this was due to issues with homelessness and would welcome support of the Board in tackling this through work with partners in the housing sector.

It was concerning that some referrals for services were being rejected which presented an issue for referrers and communication was key if thresholds were not met. The officer agreed that communication was key and ensuring there was a two-way dialogue with primary care services to advise that referrals may be s best suited elsewhere.  Further work was planned on communication to further provide information on other various pathways.

It was asked how Medway compared to the rest of the country in terms of patient beds and the Board was informed that compared to national, KMPT across Kent and Medway had one of the lowest bed stocks at 15 beds per 100,000 for younger adults. Addressing this continued to be an area of priority. Bed stock was dictated by the mental health long term plan, there were many people taking up beds that have complex needs but did not necessarily need to be in the acute service.

The Assistant Director Adult Social Care added that Medway had one of the largest diagnoses of dementia and work was being done on how to change the current model to achieve quicker diagnosis as the current timeline was too long.  In terms of discharge planning, one of the struggles was with younger patients who may need supported living and it was vital that discharge planning commenced right from the beginning of the process, prior to a proposed discharge date.  The officer agreed that discharge planning should commence from the time of admission, and this was a cultural change that was needed for the whole service.

The Chief Strategy Officer ICB added that it was important to explore ways to work together as a Board to support the population of Medway. Considering the points raised during discussions on mental and physical health, it was key to explore opportunities together to improve outcomes for the changing population. KMPT was the only organisation that provided support for people with dementia and with an ageing population, this model would need to change. The NHS needed to consider where to locate resources that the population could easily access and support the population to navigate the move from secondary to primary care services where appropriate, recognising the boundary of what secondary care could provide and what could be achieved through community work.

It was also important for practitioners and the community to recognise that A&E was not the best place for people in a mental health crisis although it continued to be one of the main places that people presented to. More needed to be done to raise awareness on the appropriate services for people in crisis.

Decision:

1. The Board noted the report.

2. Opportunities to enhance transformation that presented itself be recognised and taken up by all partners.

3. The Board lends its support in tackling issues of placements through the housing and social care teams for supported housing or specialist accommodation for people in acute services ready for discharge.