Issue - items at meetings - Mental Health Beds Update

Update from Sussex Partnership NHS Foundation Trust (SPFT) and the Brighton & Hove Clinical Commissioning Group (CCG) on the temporary closure of in-patient acute mental health beds at Mill View hospital (verbal)

19.1Anne Foster, Clinical Commissioning Group Lead Commissioner, Mental Health and Sam Allen, Sussex Partnership NHS Foundation Trust (SPFT) Service Director, provided the committee with a verbal update on the decision taken by the Clinical Review Group at its last meeting regarding the temporary acute mental health beds at Mill View Hospital. The HWOSC had asked for a verbal update from the meeting.

19.2Ms Foster said that, since the last HWOSC meeting, the clinical review group had held, as planned, a further meeting. The group, which consists of six clinicians from across SPFT and chaired by the GP Mental Health Lead at the CCG, had carefully considered the current situation with the temporary bed closures and on balance, had decided not to re-open them.

The clinicians felt that, in their experience, if a bed was available, it would be filled; this might artificially alter the threshold for managing patients in the community. Instead, the review group opted to use the resources freed up by the bed closures to invest in community services and other improvements in acute mental health services e.g. discharge team. The review group felt that it was vital to make further improvements to the Crisis Resolution Home Treatment Team (CRHT), and in particular to bolster night-time support as well as looking at enhancements to reduce the length of a patient’s stay.

19.3Ms Allen clarified the decision taken by the clinicians regarding the closure of the beds is contingent on further investment (as outlined above) in community services. The preferred model of care is for patients to be managed in the community as much as possible because of the continuity of care with community teams and family and social support networks. There had already been progress in reducing the length of stay since the introduction of the early discharge coordinator at the start of June. 
 

19.4Ms Foster and Ms Allen commented on the fact that although it had not been possible to meet the 95% target for accommodating people within Brighton and Hove, this had only dipped to 93%.  They mentioned however that one risk to be aware of was that, if homelessness figures increase, this could put additional pressures on the acute services,

19.5The committee heard that there was further work ongoing to prioritise the investment in community services and that the clinical review group will meet again in August to make a final decision on investment. The impact of the investment would be monitored over a period of two to three months to assess its sustainability before making a permanent decision on the future of the beds.

19.6Councillor Rufus said that he was surprised by the review group’s decision and asked how quickly would the extra community support resources have a meaningful effect on the metrics?

19.7Ms Allen said the investment proposals had already been developed; additional services could be in place by September 2012 and should quickly be able to demonstrate their outcomes. The Early Discharge Team was already having a positive impact, and it was hoped to extend their services to make them available for seven days a week.

19.8Committee members said that they were disappointed with the decision not to re-open the beds. They would also have liked to have had a written report available on such an important issue.

Ms Foster and Ms Allen explained that it was not possible to have provided a written report; the tight deadlines with the clinicians’ meeting had meant that it was not possible on this occasion.  They confirmed that a written report will be provided to the next HWOSC meetings. Councillor Rufus welcomed this confirmation.

19.9Mr Eddie, for the Youth Council, asked about the effect that the bed closures would have on the families of patients, in particular those who might be placed out of the area. Ms Allen said that SPFT would always try and provide someone with their first choice of accommodation location where possible; SPFT has beds across Sussex. It was often the case the patients preferred to be cared for in their own homes; the new investment in community services would support this.

19.10    Ms Hoban from the CCG confirmed that clinicians would continually review the situation following the additional investment. Investment was immediately available for some of the services to increase capacity, but in addition to this the CCG were also progressing other plans including the personality disorder day facility and increased capacity in terms of supported accommodation; these changes would come in during 2013. This was part of a long transformational journey for mental health services, following an extensive independent review of services.  The new arrangements would be carefully monitored; it was about getting the model of care right and addressing a systemic imbalance.

19.11    Clodagh Warde-Robinson, Deputy Chief Executive from the Sussex Community Trust, said that they had been through a similar process in West Sussex and stressed the need for a formal evaluation of the programme, and the potential knock on effect for other services. Ms Warde-Robinson, Ms Allen and Ms Foster agreed to continue the discussion following the committee meeting and agreed to keep Councillor Rufus and HWOSC members updated with any outcomes.

19.12    Mr Watkins, representing the LINk, said that he was very disappointed with the decision and felt that the community he represented would be unhappy too. He asked that any future reports about the bed closures be sent to the LINk.

19.13    Councillor Wealls said that he disagreed with the majority of committee members as he felt that it should be clinicians directing priorities.

19.14    Ms Warde-Robinson spoke in support of the proposed changes, commenting that it was necessary to take some of the capacity out of a service in order to transform it and change behaviours. If changes were not made, behaviours would not change.

19.15    RESOLVED – that the verbal report be noted and that written reports on the situation regarding the bed closures be brought to all future HWOSC meetings whilst this was a live issue.