Agenda and minutes

To receive any apologies for absence

Claire Andrews (HFOP)

The Chair will consider the admission of any late items of urgent business.  (Late items will be considered under the agenda item where they appear.  New items will be dealt with at item 9 below).

None received

A member with a disclosable pecuniary interest or a prejudicial interest in a matter who attends a meeting of the authority at which the matter is considered:

i) must disclose the interest at the start of the meeting or when the interest becomes apparent, and

ii) may not participate in any discussion or vote on the matter and must withdraw from the meeting room.

A member who discloses at a meeting a disclosable pecuniary interest which is not registered in the Member’s Register of Interests or the subject of a pending notification must notify the Monitoring Officer of the interest within 28 days of the disclosure.

Disclosable pecuniary interests, personal interests and prejudicial interests are defined at Paragraphs 5-7 and Appendix A of the Member’s Code of Conduct.

None received

To receive a presentation from the Mental Health Trust on the proposed closure of Downhills Ward.

Attending:

Maria Kane – Chief Executive

Lee Bojtor – Chief Operating Officer

Oliver Treacy – Service Director

Andrew Wright – Director of Strategic Development

PRESENTATION TO FOLLOW

The Panel received a presentation from the Barnet, Enfield and Haringey Mental Health Trust.

Key points noted:

·        Sincere apologies for the poor communication regarding Downhills Ward.

·        The Trust is committed to learn from mistakes made and is reviewing their communications policy.

·        ‘Changing for Good’ is an on-going initiative, which the MHT has had an on-going dialogue with Overview and Scrutiny about.

·        http://www.beh-mht.nhs.uk/changing-for-good.htm

·        Beds don’t necessarily equate to better care.

·        Patients spending too long on Wards isn’t always good for them and can make them go downhill again.

·        Some Wards across the MHT have consistently got empty beds.

·        There is therefore a point where there is a need to look at consolidation.  It was felt that this was the point reached in relation to Downhills Ward.

·        Downhills Ward has consistently had the poorest quality environment, a point which has also been raised by the Care Quality Commission.

·        Better stock will be available once St Ann’s is redeveloped.  However this is 2 ½ years away.

·        Options currently being considered are for the interim period in the lead up to the site redevelopment.  These options are:

o       Looking at whether we can adapt the wards at St Ann’s to allow mixed sex use – this would be very difficult and very expensive, given the wards will be replaced by 2015

o       Moving the assessment ward to Chase Farm and having separate male and female treatment wards at St Ann's in the interim – this would ease the travel difficulties for carers and other visitors of longer stay patients as only assessment patients would be affected

o       Combining assessment  and treatment beds on each of the remaining male and female wards – the preferred option

o       We are also looking at how we could provide additional support for carers of patients if temporarily accommodated at Chase Farm, e.g. a free regular shuttle bus between St Ann’s and Chase Farm

In response to questions from the Panel and other attendees the following points were noted:

·        The announced closure of Downhills Ward in September was felt to be an operational and service decision as it was part of wider discussions on the service model and was therefore taken by the Crisis and Emergency Line.

·        However, the Communication Policy was not followed in this case.

·        There are clinical safety considerations e.g. having to correct ratio of staff to patients – as capacity reduces any staff absence can have a bigger impact and therefore bigger clinical concerns.

·        It is estimated that changes would impact approximately 10 patients per month.

·        2 ½ years is a realistic time frame for the redevelopment of St Ann’s.

·        There was some confusion on the number of patients on Downhills Ward as of the date of the meeting.

·        There are no new admissions to Downhills Ward.  Any additional beds used where due to moving people around as opposed to admitting.

·        It would not be cost effective to keep Downhills Ward open for new admissions during the consultation as there were too many empty beds  ...  view the full minutes text for item 17.

To hear from the Mental Health Support Association.

The Panel heard from Anne Clancy, the mother of a current patient on Downhills Ward and also received an email submission.  Points made included:

·        The Home Treatment Team is over whelmed and on its knees.

·        There is no continuity.

·        Beds have always been full over the past ten years.

·        Mrs Clancy’s daughter has experienced times when the Ward has been over flowing and she has had to go and sleep somewhere else.  Places have included a geriatric ward and Barnet General hospital.  This has caused a relapse when she has been on the cusp of recovery.

·        Feels it is counter-productive to take people out of their communities.

·        When it was announced that Downhills Ward would close there were 9 patients on the Ward (including her daughter).

·        At this time there was no mention of the options which had been outlined earlier by the MHT.

·        In August Mrs Clancy had been told that Downhills Ward would not be closing.

·        The distress and trauma inflicted upon patients on the Ward was felt to be outrageous.

·        Asked for reassurance that options mentioned will be monitored to ensure they are implemented.  The Chair of the Panel informed Mrs Clancy that the Panel would be monitoring.

The Panel heard from the Haringey User Network that:

·        There is poor satisfaction amongst service users of the Home Treatment Teams.

·        That there are 8 beds in the Haringey Recovery House and 4 each in Barnet and Enfield.

·        There were examples of health professionals calling to admit people to Recovery Houses but being told there was no space and therefore having to treat them in the community.

·        Service Users want a Home Treatment Team service which is working, which it is not felt to be at present.

·        It is not the time to be closing beds.

·        With regards to bed numbers at St Ann’s – Haringey Ward has 12 beds, Finsbury Ward has 18 beds and Downhills Ward has 18 beds.

·        Feeling that no answers are providing by the MHT and very little notice given to service users/patients, their carers and families.

The Panel heard from Ms. Campbell, patients mother, who expressed that she was still in shock what had happened with the announced closure and was also still very concerned about her daughter being moved at a time that she is making progress.

The Panel heard from MIND in Haringey that:

·        It was good that more people are being treated at home, but there are flaws in the system for example, people find it difficult to contact Home Treatment Teams.

·        Pets are very important to people and patients at St Ann’s are currently able to pop home to check on their pets, if patients were moved further away this would not be possible.

·        Advocacy provision would be much more difficult should patients be moved out of St Ann’s to a location further away/harder to reach.

·        People would prefer to be more local to their homes and communities that to have facilities such as an ensuite.

In response  ...  view the full minutes text for item 18.

The Panel will consider next steps and any recommendations.

·        The Mental Health Support Association requested more information on the financial background to reassure service users, carers and families that changes are based on strategy rather than cost savings.

·        Noted that there was a need for transparency with changes, and that MHT Board papers are available to the public via the MHT website.

·        A decision on options would be needed sooner rather than later and any work to be done would be needed to be done over the next month.

·        The Panel asked that Downhills Ward remain open to new patients whilst discussions on proposed options take place.   It was noted that this was technically possible but it would mean that some patients would then be in the position where they were faced with being moved at a later date after being admitted to Downhills Ward.   There are also financial implications to consider.

AGREED:

·        That a working group would be set up with a view to making recommendations on options. 

·        That this working group would meet over the next month and would complete its work within the month.

·        That Maria Kane, CE, BEH MHT would write to the Panel within 48 hrs to address issues raised during the meeting.

Deferred

10^th December, 6.30pm (Budget Scrutiny)

10^th January, 6.30pm

2^nd April, 6.30pm

10^th December, 18:30

10^th January, 2013, 18:30

2^nd April 2013, 18:30

To consider any items admitted at item 2 above

None