Agenda item

This report sets out the implementation plan for the acute services redesign received from West Kent CCG as the commissioners for acute mental health for Kent and Medway, in response to the recent reconfiguration proposals and as promised at the last meeting of the Joint Health Scrutiny Committee between Kent and Medway held on 30 July 2013.

Discussion:

The Chief Officer of West Kent Clinical Commissioning Group introduced the report with the Chief Executive, Kent and Medway NHS and Social Care Partnership Trust and the Chief Clinical Officer, NHS Medway CCG and

responded to the list of issues circulated in advance of the meeting.

The following points were made:

• There was confidence that the 174 beds could be found across the three identified sites but no assurances could be given that the stated number would be sufficient overall bearing in mind the unprecedented increase in demand for acute beds nationally over the past few months which could potentially be sustained
• The detailed implementation plan had been submitted to the Council within the required timescale
• Plans were underway for the crisis house in Medway but this was not to be a health facility as that would require complex regulation
• Regular performance monitoring meetings were held with NHS England about the plans
• In relation to out of area placements it was stated that, at that moment, there were 18 out of area placements across Kent and Medway, but only 5 related to Medway service users
• The concept of ‘centres of excellence’ was well understood by those commissioning and providing services but it was accepted that more needed to be done to relay that concept to the wider public and service users in particular
• There was now 24/7 support in A&E at Medway Maritime Hospital for people with mental health problems and a third support worker was starting work in January
• GPs were receiving support and training in relation to mental health issues
• Support groups in Medway – particularly MEGAN and Rethink were assisting with work on reaching hard to reach groups in the community to ensure people were supported with their mental health issues
• There were plans for the commissioning of acute mental health for Medway to be dealt with by Medway CCG in the future rather than West Kent CCG
• Following the reporting of the reconfiguration to the Secretary of State information had been requested from the NHS to triangulate evidence
• Clarification was given that beds could not be reserved or allocated to a particular area
• Recognition was given to the fact that if it had not been for the persistence of Medway Members on the Joint Health Overview and Scrutiny Committee the current planning would have been for a lesser number of acute mental health inpatient beds

The Deputy Director, Children and Adults referred to the need for multi-disciplinary working as social care was a vital element of any plans for people with acute mental health problems.  As such he felt there was a duty for partners to work together to meet the needs of these service users and their carers.

The Chief Executive of Kent and Medway NHS and Social Care Partnership Trust (KMPT) responded to a question regarding the bed usage in Medway, and level of occupancy and stated that she could provide a graph showing the usage at a later date.  She stated that at present there were 160 beds across the three sites and that additional funding had been put in place to assist with transporting carers to visit their relatives.  There were now six additional beds, which had become available at Dudley Venables House in Canterbury due to the running down of the Psychiatric Intensive Care Unit there.  The refurbishment at Dudley Venables House was scheduled to commence in February and be completed by June 2014.  Following a further question she then agreed to report back on the number of acute inpatient beds in Kent and Medway, which had en-suite facilities available.  An undertaking was also given that beds would not be closed in A block until the additional beds elsewhere were available.

Mr Antonio and Mr Clark, who, as members of the public with direct personal experience of services provided in Kent and Medway for people with acute mental illness, and who had taken part in the full consultation process on acute beds, addressed the Committee.

Mr Antonio made the following points:

• In his opinion there was potential for A block to be adapted at a much lower figure than had been quoted, particularly bearing in mind that few of the inpatient beds currently had en-suite facilities so A block could have been adapted without them.  If that had happened the provision would have been in the best place according to need and could have been achieved at a lower cost
• There had been a catalogue of errors in the predictions/information presented as part of the process which he felt to be flawed
• £900k had been spent on out of area placements in one month by KMPT
• In his opinion he felt the Secretary of State should have requested a full review of the reconfiguration plans
• The high level of suicides and unexplained deaths in the area of Kent and Medway was referred to

Mr Clark referred to his own personal experience and detailed some of the shortcomings in the service he felt had been provided by the mental health trust, Kent and Medway NHS and Social Care Partnership Trust, which had led to a very stressful situation for him and his family.

Members expressed their extreme disappointment at the redistribution of acute inpatient mental health beds away from Medway, which they felt could only impact badly on Medway’s service users and their carers.  The view was expressed that Medway had been served poorly in the overall plans.

A request was made for more information about the implementation plan for the next meeting.  The Chief Officer, West Kent CCG stated that there would not be much that could be shared at that point because the plans would need to go to the KMPT Board meeting in January and as such would not be in the public domain at the time of the Committee’s agenda despatch.

Responding to Members’ questions he confirmed that, in the event of KMPT not being able to provide the required bed numbers, he would need to give consideration to acquiring them from a different provider.

Decision:

(a)   It was agreed that the position with regards to acute beds should be kept under permanent review with a report to each meeting of the Committee until further notice;

(b)   In the interim it was agreed that the information requested at the meeting would be provided to the Committee.