Issue - items at meetings - Sussex Partnership NHS Foundation Trust (SPFT): Planned Service Developments in Brighton & Hove

Verbal update by Darren Grayson, Chief Executive NHS Brighton & Hove, and Lisa Rodrigues, Chief Executive, Sussex Partnership NHS Foundation Trust, on plans to re-design local mental health services

54.1    This item was introduced by Darren Grayson, Chief Executive, NHS Brighton & Hove (NHSBH), and by Lisa Rodrigues, Chief Executive, Sussex Partnership NHS Foundation Trust (SPFT)

54.2    Mr Grayson explained that NHSBH and SPFT were still considering how best to reconfigure mental health services for the residents of Brighton & Hove, and were therefore not in a position to present their reconfiguration options to the HOSC at this time. In consequence, the Brighton & Hove aspect of the reconfiguration initiative was being postponed until (probably) the early summer, when NHSBH and SPFT could be confident of putting forward the best possible reconfiguration options/consultation plans.

54.3    Ms Rodrigues told the committee that, although the reconfiguration initiative was on hold in Brighton & Hove, improvements to Mill View hospital were ongoing, particularly in terms of re-designing hospital services in order to be able to offer an ‘ageless’ service, in line with recent national guidance, and in terms of developing a ‘Section 136 Place of Safety Suite’ (a facility where people detained by the police under S136 of the Mental Health Act can be appropriately diagnosed).

54.4    In response to a question about the likely consultation period, Mr Grayson told members that this was currently unclear, as elements of the reconfiguration plans had not yet been agreed: the more substantial the changes mooted, the more likely it was that there would need to be a lengthy consultation period. Mr Grayson also reminded committee members that the HOSC had an important statutory role to play in working with NHS trusts in order to determine the scope and detail of public consultations.

54.5    The Chairman thanked Mr Grayson and Ms Rodrigues for their contributions.

Report of the Director of Strategy and Governance  on planned changes to Sussex-wide mental health commissioning (copy attached). Richard Ford, Executive Commercial Director, Sussex Partnership NHS Foundation Trust, will give a presentation on the Partnership Trust’s “Better By Design” initiative.

34.1    This Item was introduced by Claire Quigley, Director of Delivery, NHS Brighton & Hove. The committee also received presentations from Geraldine Hoban, Deputy Director of Commissioning, NHS Brighton & Hove, and Richard Ford, Executive Commercial Director, Sussex Partnership NHS Foundation Trust.

34.2    In answer to a question about the anticipated reduction in the number of in-patient mental health beds across Sussex, members were told that detailed work on this area had yet to be undertaken, but that Sussex mental health services appeared over-reliant upon in-patient beds compared to regional and national averages and to established models of best practice.

34.3    In response to a query as to whether the relatively high local spend on mental health services might in fact be necessary to ensure good outcomes, the committee was informed that it was not always easy to show a clear link between investment in mental health services and improved health outcomes, so the question was a difficult one to answer. However, the city does have very long mental health bed stays compared to national/regional averages, and there is a broadly accepted correlation between unnecessarily lengthy bed stays and poorer outcomes for mental health patients (e.g. loss of independence, loss of work, housing difficulties etc). Therefore, at least in relation to length of stay, there is a compelling argument to say that less reliance on in-patient treatments would be likely to improve rather than worsen health outcomes.

34.4    In answer to a question about whether the proposed reconfiguration of mental health services was a reaction to anticipated ‘real-terms’ reductions in healthcare funding post 2011, members were told that it was only sensible to plan for  reduced funding (or a slower growth in funding), rather than to respond reactively to a funding crisis. However, both the commissioners and the providers of local statutory mental healthcare services believed that greater efficiencies, particularly in terms of reducing length of stay in in-patient beds, would allow local mental health services to maintain or improve on their current quality, even in a more hostile financial climate.

34.5    Other necessary improvements in local mental health services would entail better partnership working with the ‘3^rd sector’; more innovation (particularly in terms of repatriating to Sussex specialist services currently provided in out-of-county settings); better compliance with NICE (National Institute for Clinical Excellence) guidelines; improved access to services; better IT systems (particularly in relation to patient records); more consistent standards of care across Sussex; a rationalisation of SPFT’s estates; the development of specialist services (notably for dementia, dual diagnosis, personality disorders and learning disability services) and an increased focus on the mental health of trust employees.

34.6    In response to a question as to how quality could be maintained at the same time as shortening bed stays, members were told that effective discharge planning was key. Planning for a patient’s discharge should commence as soon as they are admitted to hospital, so as to ensure that they can be discharged as quickly as possible once it is clinically safe to do so.

34.7    RESOLVED – That the report be noted.