Agenda item

This report covers the activity of the Working Group, its findings and recommendations made to the Trust on behalf of the Board.

Declarations of interest:

None

Witnesses:

Justin Wilson, Medical Director, Surrey and Borders Partnership NHS Foundation Trust

Don Illman, Lead Governor, Surrey and Borders Partnership NHS Foundation Trust

Bill Chapman, Tim Hall and Tony Axelrod, Members of the working group

Matthew Parris, Evidence and Insight Manager, Healthwatch Surrey.

Key points raised during the discussion:

1.    The Medical Director began by explaining that the ward re-location had taken place at the beginning of February and that the move had been successful.  He explained that the new location provided a much improved environment for inpatients.  Furthermore, the vast majority of nurses had transferred across to the Abraham Cowley Unit (ACU) and medical staffing levels had been augmented in order to support junior doctors.  The Board was informed that the success of the move would be evaluated from a patient experience perspective and its impact on missing persons (MISPER) data would also be analysed.

2.    The Lead Governor raised concerns that four nurses had left Surrey and Borders Partnership (SABP) as a result of the move, and a further four had found new jobs nearer to where they lived.  He went on to state that whilst the physical environment at the ACU was fresh and newly refurbished, the rooms were still dormitories and therefore lacked a degree of privacy.  The Medical Director pointed out that whilst the rooms were not individual en-suite rooms, the move had enabled wards to become single-sex rather than mixed-sex as they were at Epsom and that this was considered to be a significant improvement. 

3.    The Lead Governor told the Board that a consultation carried out in 2009 supported the case for three mental health hospitals within Surrey.  The east of Surrey currently has no beds since the move to ACU was implemented.  The Medical Director acknowledged the lack of facilities in the east of the county but explained that the consolidation of services onto fewer sites allowed for improved care provision to inpatients and consolidated medical support.  Furthermore, he explained that SABP had a contract with Sussex to be able to use 14 beds at Langley Green if SABP reached their full capacity. 

4.    A Member of the working group commented on the conditions observed during his visit to the Epsom based wards prior to the move to the ACU.  He told the Board that the doors to the entire unit, including the stroke unit above, had to be locked whilst staff moved inpatients to and from the servery area at mealtimes due to a shared public thoroughfare.  

5.    The Lead Governor raised concern that there was no public consultation regarding the decision to move the two wards from Epsom to the ACU, and that if this was a stroke or maternity ward being moved, there would have been public outcry.  The Medical Director explained that the consultation carried out in 2009 supported the decision.  The security and safety arrangements at the Epsom wards were of concern to the Trust, despite mitigations being implemented.  Furthermore, patient experience survey results at Epsom were not positive and this helped form part of the decision to relocate the services.  The Medical Director explained that the decision was taken to implement the ward relocation as fast as possible after the opening of the Farnham Road hospital. 

6.    A Member of the working group endorsed the decision of the move, however raised concerns around the circumstances and speed at which the move was announced and implemented.  He explained that the temporary move to the ACU would have been more acceptable if a decision had been made about the location of the second mental health hospital site, given that this will take approximately five years to build.  

7.    Members sought clarity regarding the current status of the second hospital site.  The Medical Director explained that the previous consultation, in 2009, indicated a preferred geographical outcome of three mental health hospitals for Surrey, although SABP would prefer a two hospital solution based on the number of beds required.  He stated that there were strategic options with varying costs for sites in Redhill, Chertsey, West Park and Epsom, although no decisions would be made until after the consultation process.  The Medical Director explained that the consultation for the second site had been scheduled to begin in early 2017, however this had not yet commenced and that the commissioners would be leading on the consultation programme. 

8.    The Board raised concerns regarding travel arrangements to the ACU for the friends and families of inpatients.  A Member of the working group explained that he had travelled by public transport to the ACU to test accessibility and that his journey was manageable, however he recognised it could be a struggle dependent on where they were travelling from.  Another Member enquired as to whether a minibus service from Woking or Chertsey stations had been considered by the Trust to mitigate travel concerns.  The Medical Director explained that a shuttle-bus service was in place for staff, however for patient visits, due to low volumes of numbers and the frequency of visits that generally took place, taxis would be the most cost-effective option.

9.    Members were concerned that families visiting from the East of Surrey could face a long commute and that this may have a negative effect on patients as visits could become less frequent.  The Board was assured that this impact would be measured.    

10.  The witness from Healthwatch Surrey explained that recent visits to safe havens in Surrey had identified that service users had concerns about funding cuts for safe haven services as of April 2017.  The Medical Director stated that the Trust was committed to supporting the work of the safe havens, as they provided a cost-effective way of improving bed availability and a positive impact on service users. 

Recommendations

• That the Trust review the process by which it plans future ward relocations, in order to improve its change management practices.

• That the Trust set out timescales for consultation and anticipated impact on current services, and that the Board receive an update during consultation.

• That the Trust produce a travel plan to demonstrate how people and their families will be supported to access the Abraham Cowley Unit.

• That the Trust provide additional resource to support people who use the wards to access Skype and other communication tools, where appropriate.

• That the Trust monitor family and patient feedback following the move and provide a summary of key themes for the Board in six months’ time.

• That the Trust report the impact on Missing Person rates to the Board in six months’ time.

• That the Trust and commissioner clarify the position on funding for the safe haven in Epsom.