Agenda item

Following a decision taken by the Joint Health Scrutiny Committee with Kent County Council on 30 July 2013 this Committee is asked to consider whether to refer the decision to the Secretary of State if it considers that the reconfiguration is not in the health interests of Medway residents. 

Discussion:

The Deputy Director, Customer Contact, Culture, Leisure, Culture, Democracy and Governance introduced a report on the scrutiny undertaken by the Joint Health Scrutiny Committee between Medway Council and Kent County Council in relation to acute mental health inpatient beds.

He stated that the proposals involved the closure of ‘A’ Block at Medway Hospital, the loss of the 35 adult mental health inpatient beds there and the provision of inpatient beds instead at locations elsewhere in Kent with Medway patients having access to beds at Litttlebrook in Dartford and Maidstone.

Whilst Medway Members have accepted that ‘A’ Block is no longer fit for purpose they have consistently expressed concern at the loss of beds for Medway patients in Medway and the lack of an option to provide an alternative local facility because the NHS have said it would be too expensive.

He emphasised that this report set out the outcome of the work of the Joint HOSC culminating in a majority decision on 30 July to support the reconfiguration subject to various conditions as set out in paragraph 2.6 of the report. He explained that Medway Members had abstained from the vote on 30th July and have asked that this Committee should consider their outstanding concerns set out in paragraph 3.3 on page 17 of the report and whether or not the Committee should exercise its right to make a report to the Secretary of State.

He stated that this was a matter for Members. In taking a view the Committee should weigh up the action the NHS was now proposing to address Medway's concerns as set out in para 3.1(b) including additional investment in community based services, provision of a recovery house and access to acute beds in Maidstone.  This should be weighed against the concerns Medway Members have expressed over the flawed data on which the proposal was based, the advice of James Fitton, who provided an expert opinion to the Joint HOSC and the absence of local provision in Medway given the size of its population and levels of deprivation.  The ongoing heavy reliance on out of area placements should also be borne in mind.

He added that the report from the NHS to the Joint HOSC on 30 July stated that Medway Foundation Trust (MFT) requires Kent and Medway NHS and Social Care Partnership Trust (KMPT) to vacate ‘A’ Block.  Councillor Wildey had sought confirmation of this from MFT and been advised this was not the case and that the Trust had not yet finalised a plan for the reconfiguration of the hospital site post-Keogh, and in any case cannot, under the terms of the lease, serve notice on KMPT.

He emphasised that the Committee was not being asked to revisit the issues in any depth this evening as that had been the job of the Joint HOSC but to decide whether or not this is a service development that can and should be reported to the Secretary of State seeking his intervention. The decisions the Committee was required to take were set out in paragraph 6 of the report.

Richard Iddenden questioned the outcome of the KMPT consultation with service users and whether the feedback had been received.  The Deputy Director, Children and Adults stated that this information had been supplied to the last JHOSC meeting.

Following the updated position Members expressed their disappointment at the stance taken by Kent Members at the JHOSC and the lack of confidence they felt they could have in the undertakings given in relation to acute inpatient mental health beds for the area. 

It was stated that there had been few assurances that community services were being strengthened, in spite of promises to the contrary.  A recent example was given of a family in Medway that had been left without support in spite of their attempts to contact the community mental health team.  There also did not appear to be any clear vision about what a centre of excellence would look like.

The point was made that Medway had been forced to press the case for information throughout the process of the review and had to meet the major part of the funding for the independent review undertaken by James Fitton.  In the circumstances it seemed appropriate now to report the matter to the Secretary of State.

A proposal was put to report the matter to the Secretary of State as set out below.  This was unanimously agreed. 

Decision:

(a)          That this Committee exercises the power to report to the Secretary of State about the proposed reconfiguration of acute mental health services on the following two grounds:

1.                  The local authority is not satisfied that the consultation on acute beds has been adequate on the grounds of seriously flawed data presented by the NHS, limited options and other errors made throughout the consultation process and

2.                  The local authority considers that the proposal would not be in the best interests of the health services in the area of Medway.

And call on the Secretary of State to:

(i)     note the serious flaws in the data on which this service reconfiguration was based and the attempt by the NHS to disregard and dismiss the serious concerns raised about this by the families of service users and Medway Councillors over the Autumn and Winter of 2012/13 and the consequential lack of confidence of Medway Councillors in the methodology used to assess the number of beds required, particularly since reliance and expenditure on out of area acute in-patient placements has increased massively with no clear explanation for this

(ii)    direct the NHS to ensure that the number of acute mental health beds and community based services in Kent and in Medway are provided at levels equivalent to the highest levels of provision in the comparator areas considered by the independent evaluation commissioned by Kent County Council and Medway Council and provided by James Fitton

(iii)       direct that Medway residents must be able to access acute psychiatric in-patient beds in Medway rather than being required to travel to provision far away from this main centre of population and relative deprivation

(iv)        ensure that the action promised by the NHS on 30 July and the additional action called for by the Joint HOSC to strengthen community based mental health services is fully implemented against clear milestones and measurable improved outcomes for service users

(b)       that authority be delegated to the Deputy Director, Customer Contact, Leisure, Culture, Democracy and Governance to take the necessary steps to make the report in consultation with the Chairman and opposition spokespersons of this Committee and

(c)        that the West Kent CCG are notified of the decision to report to the Secretary of State by 3 September 2013 as the date on which the report will be made.