Agenda item

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 across the MHT.

·        The LINk raised concerns that procedures had not been followed and questioned reassurances that the situation would not occur again.

·        The Recovery House programme was fully consulted on, the closure of Downhills Ward was based on this programme.  However, MHT acknowledged that they had forgotten to remind people of this.

·        At the time of the Recovery House programme consultation it was agreed that beds would be kept until Recovery Houses were at full capacity, this point had now been reached.

·        The Communication Policy now states that any decision to close a Ward should go to the MHT Board.

·        The MHT can never say 100% that every Haringey resident will be treated in Haringey as this is not practical due to fluctuations in need and the flow across the whole of the Trust and the three Boroughs covered.

·        Concerns were raised that the mental health needs of residents in some of the most deprived areas would not be met during the redevelopment and that those with mental health needs, women, families of those with mental health needs and those in deprived areas would be disadvantaged.

·        Wards had previously been be both treatment and assessment but splitting them helps to manage the pathway better.  The MHT now felt that Clinicians had found a way in which both could be done on one Ward but keeping assessment and treatment elements very separate in order to get the best results.

AGREED:

·        That the Communications Policy would come to a future meeting of the Adults and Health Scrutiny Panel for consideration and to reassure the Panel that it would not fail in future.

·        That the Panel would receive an update in the New Year on the overall strategy and the current and future position with regards to the position.

·        That the Panel would receive information on how the long term change away inpatient centred treatment and to home and community based models is progressing, with special emphasis on how the new ways of working are being implemented form the point of view of clients, carers and mental health groups at a Panel meeting in the New Year.