Agenda item

Purpose of the report:

To update the Committee on their Recommendations following the relocation of Delius and Elgar wards (Epsom) to the Abraham Cowley Unit (Chertsey). 

Declarations of interest:

An interest was declared by Mr Bill Chapman as a member of the governing body of Surrey & Borders Partnership NHS Foundation Trust.

Witnesses:

Don Illman, Chairman, Surrey & North East Hampshire Independent Mental Health Network

Matthew Parris, Deputy Chief Executive, Healthwatch Surrey

Lorna Payne, Chief Operating Officer, Surrey and Borders Partnership

Dr Justin Wilson, Chief Medical Officer, Surrey and Borders Partnership

Key points raised during the discussion:

Mr John O’Reilly and Mr Graham Ellwood arrived at the meeting 10.12am.

1.     The item was introduced by officers who advised the Committee that the purpose of the report was to update Members on progress by Surrey and Borders Partnership NHS Foundation Trust against a series of recommendations which had been put forward by Surrey County Council’s Wellbeing and Health Scrutiny Board (WHSB). Members were informed that positive progress had been made against the majority of recommendations made by WHSB.

2.     The WHSB had also requested that the report include an update on Missing Persons rates from the Trust and Members were informed that an overall reduction had been recorded in the number of patients absconding from mental health inpatient wards operated by SABP despite a spike in cases of patients being reported as Absent Without Leave (AWOL) during late summer/ early autumn 2017. New practices had been introduced at the Abraham Cowley Unit (ACU) which had contributed to reducing the number of patients absconding from the ward and had led to a reduction in Missing Persons rates across the Trust as a whole.

3.     Discussion took place regarding the relocation of inpatient service from the Delius and Elgar wards at Epsom Hospital to the ACU at St Peter’s Hospital in Chertsey. Members inquired as to what lessons SABP had drawn from the move which could be applied to any future proposals for reconfiguring mental health inpatient services in the county. Officers stated that the Trust had learned a great deal from its experience in relocating the Delius and Elgar wards particularly around communicating with key stakeholders as well as with patients and their families on proposed changes to service provision.

4.     Members highlighted the results of SABP’s patient satisfaction survey which demonstrated that Delius was the most popular ward among inpatients and inquired as to why this was. The Committee was informed that there were a range of factors that influenced patients’ views on a particular ward and so it was hard to pinpoint a specific reason as to why Delius was the most popular ward among those surveyed by the Trust. Officers did, however, highlight that the challenging environmental conditions did not prevent good practice from taking place at Delius Ward.

5.     The Deputy Chief Executive of Healthwatch Surrey informed the Committee that Healthwatch, as an independent watchdog, had held 15 events in the catchment area of Delius and Elgar since April 2017 but had not heard any issues related to the handling of the transfer which supported the Trust’s assessment of the success of the transfer. Of 25 experiences reported to Healthwatch since April 2017, there had been an equal number of positive and negative comments in relation to inpatient services at ACU although concern was raised by Healthwatch regarding the capacity of the new wards at ACU to accommodate increased demand. The Deputy CEO of Healthwatch Surrey shared a recent Case Study with Committee Members which highlighted the need to remain alert to the issue of accommodating increased demand at ACU although it was noted that the Trust was very responsive in addressing the specifics of the case.

6.     Discussion turned to the accessibility of the ACU for patient and their families particularly for those located in the Southeast of the County which was previously served by the Delius and Elgar wards at Epsom Hospital. Members inquired as to whether Healthwatch had received any complaints about support for travelling distances for patients accessing inpatient services. The Committee was advised that Healthwatch had not received any specific complaints regarding the accessibility of the ACU although it was highlighted that those receiving treatment in mental health inpatient wards could be hard to reach and so evidence regarding the accessibility of ACU was hard to obtain.

7.     The Chairman of Surrey & North East Hampshire Independent Mental Health Network highlighted that anecdotal evidence demonstrated clear issues with accessibility for patients who lived in the east of the county. In particular, Members were informed that the ACU was hard to reach by public transport and that parking at the site was also extremely difficult which was presenting accessibility issues for both patients and visiting family members.

Mrs Victoria Young entered the meeting at 10.28am

8.     The Committee expressed concern regarding car parking arrangements for patients and their families at the ACU and asked whether this had been taken into consideration when SABP decided to relocate two of its inpatient wards to the St Peter’s Hospital site. Members further highlighted the need for SABP to be flexible in the support that they provided to patients and their families who were required to travel to the ACU from far away. Officers stated that they would review the points raised by the Committee regarding travel arrangements and car parking to help tailor the support they provided to patients and their families.

9.     Members sought further clarity on the Trust’s Missing Persons rate and asked whether patients absconding from inpatient wards was entirely due to SABP’s airlock door system. The Committee was advised that it was a combination of physical environment and staff practice which resulted in patients absconding from the inpatient unit at the ACU. Staff at the ACU don’t wear a specific uniform and there are often visitors in the ward which made identifying patients challenging in the event that they tried to abscond from the ward through the airlock door. Members were further informed that the airlock door was located within a busy area of the ward which presented additional challenges in managing who went in and out of it. Officers stated that the physical environment was much easier to manage at the ACU than it had been at the wards on the Epsom Hospital site which had contributed to a reduction in the number of Missing Persons reported across the Trust. There was, however, continued work to do with staff to ensure that the airlock door was managed appropriately at all times.

10.  The Chairman of Surrey & North East Hampshire Independent Mental Health Network highlighted that patients were well aware that tailgating was an effective method for getting through the airlock door. The Committee was advised that SABP also needed to do more to discourage patients from absconding by improving some of the social aspects of the ward. In particular, it was highlighted that a shop within the ACU had been shut down which contributed to a sense of isolation among patients.

Recommendations:

The Adults and Health Select Committee:

i.       noted the update following the consolidation of Delius and Elgar wards at the Abraham Cowley Unit, Chertsey; and

ii.      Recommended that Surrey & Borders Partnership Trust considers concerns around travel arrangements for the Abraham Cowley Unit