Agenda item

Purpose of report:

To provide an update to the Adults & Health Select Committee on the progress of plans to improve mental health hospital facilities. 

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

Diane Woods, Associate Director of Mental Health Commissioning, Surrey Clinical Commissioning Group collaborative.

Key points raised during the discussion:

1.     The Committee received an introduction to the report from officers who highlighted that the Trust had learned lessons from the consultation process which had taken place on the relocation of inpatient mental health services from Epsom to Chertsey and that this learning would inform future consultations undertaken by SABP regarding any future service reconfigurations. Modelling work commissioned by the Trust had demonstrated that SABP needed to build capacity in order to deliver inpatient services capable of meeting future demand. Members were informed that SABP was focussed on refurbishing its existing sites to maximise the use of resource and to ensure the continued provision of effective care in spite of the increasing demand. This included a plan to create 80 beds at the ACU which would move away from dormitories to private rooms for patients as well as introducing gendered wards.

2.     More detail was provided on Phase 3 of the Trust’s plan to build capacity within its inpatients services and it was highlighted that SABP would progress its plans to provide inpatient services in the east of the county which would most likely involve refurbishing the existing West Park site but other options were being discussed which included the construction of a new facility. The Committee was informed that there would be some changes to service delivery while SABP was building capacity within its inpatient services but that plans would be clearly communicated to partners in order to minimise disruption. Planning for phases 2 and 3 would also take place concurrently to ensure a joined up approach to developing inpatient capacity across the County.

3.     Further clarity was sought on the modelling which had informed the number of beds that the Trust required within its inpatient services. Witnesses from SABP stated that modelling had looked at demographic changes taking place across Surrey in conjunction with an increasing trend in people experiencing mental health problems and had concluded that more inpatient provision would be required over the coming years than had originally been anticipated.

4.     Attention was drawn to the length of time that it would take for the plans to be fully realised and Members asked how the Trust intended to ensure that services would deliver for those who needed them. The Committee was told that the Farnham Road facility in Guildford had been built prior to the most recent modelling of likely demand which had been commissioned by SABP. The Trust was committed to creating inpatient provision in the east of the County which would take place in conjunction with the refurbishment of the ACU in Chertsey.

5.     Discussions turned to the Trust’s proposal for funding plans to increase mental health bed capacity and Members asked whether the refurbishment projects contained within the plan could only proceed if the Trust completed the proposed £35m land sale. Officers confirmed that refurbishment projects put forward for Phase 2 were being financed by the £35m in receipts made from land sales and that building work could only go ahead once this money had been secured. The Committee was, however, informed that negotiations to sell land owned by SABP were advanced. In respect of Phase 3 of the Trust’s bed capacity development plan, Members were informed that discussions with commissioners around financing this were ongoing.

6.     The Committee highlighted development plans for the St Peter’s site and the Committee inquired as to SABP had coordinated with Ashford & St Peter’s Foundation Trust to align refurbishment work on the ACU. Officers indicated that discussions had taken place with Ashford & St Peter’s regarding planned construction to facilitate a more integrated approach to physical and mental health at the St Peter’s site.

7.     Members asked whether SABP’s plans would be able to cope with future demand beyond the five year scope of the project or if it would be necessary to continue expanding inpatient provision. Officers indicated that it was impossible to project future demand for mental health services with complete certainty but emphasised they were confident that the modelling which the Trust had commissioned provided an accurate projection of future demand. The trend was to treat mental health conditions in a community rather than residential setting and it was expected that this would mitigate demand over time. SABP would keep its options open and work to ensure that future expansion was possible at inpatient facilities that would undergo refurbishment.

8.     Further clarity was sought on the options that there were still undergoing consideration by the Committee and when a decision would be made on these. Members were advised that SABP had committed to proceed on the refurbishment of the ACU and that the only outstanding decision was regarding the creation of inpatient services in the east of the county. A final decision on whether to refurbish West Park or construct a new hospital was predicated on factors that were still undergoing consideration to ensure that the correct option was chosen. Members were further advised that a final decision on Phase 3 of the project would not be made for over a year but that that the timetable for the implementation of Phase 3 would enable public involvement in the decision. It had not been decided whether a full public consultation was required regarding Phase 3 but that the Select Committee would be kept informed of the process.

9.     The Committee asked how many beds there were at the ACU and were advised that there 110 beds for working age adults experiencing mental health problems and a further 11 drug and alcohol beds.

10.  Members inquired as to how Phase 3 of the bed capacity development plan sat with the Surrey Heartlands Sustainability & Transformation Partnership (STP). It was advised that conversations had taken place with STP leaders and there was a clear aspiration to improve mental health service delivery within the STP plan although discussions had not been had regarding resource allocation.

11.  Concern was expressed by Members that there had been an ongoing shortage of mental health inpatients beds in the east of the county and assurance from officers that the project would address the lack of provision within this area of the County. The Committee was informed that SABP would engage with the public around the choices available for increasing the number of inpatient beds in the east of the county before making a decision on Phase 3 of the project. Officers stated that SABP would continue to be able to place patients at the Langley Green Hospital in Crawley which would help to provide provision for patients resident in East Surrey.

12.  The Select Committee heard from the Chairman of Surrey & North East Hampshire Independent Mental Health Network representative who highlighted concern among residents about the amount of time it had been since there had been adequate provision in the east of the County. He provided Members with an overview of mental health inpatient services over the previous few years and stated that the Trust had been placing patients in Langley Green Hospital for over ten years due to a lack of sufficient provision within Surrey. He also expressed the view that the proposals outlined by SABP would not meet the rising demand that would take place over the coming years.

13.  The Healthwatch Surrey representative asked the commissioners whether they considered that there was a legitimate expectation that there should be a public consultation on the location of an additional inpatient unit in Surrey. It was advised that public engagement events would be necessary which would be supported by previous consultation work undertaken by the Committee and that the intention was to undertake consultation work on phases 2 and 3 in tandem. The Healthwatch Surrey representative drew attention to recent local experience of commissioners around consultation through the reconfiguration of the Sexual Health and HIV Services Contract which demonstrated the importance of basing any decision to consult on sound legal advice. The Cabinet Member for Health informed Members that she would raise planning for mental health inpatient provision with the Health & Wellbeing Board to ensure that it was consistent with the County’s Joint Health & Wellbeing Strategy.

14.  Discussion turned to the recommendations contained within the report and Members suggested that an update from SABP on the development of mental health inpatient provision should be delivered to the Committee before its meeting on 7 November 2018. It was agreed that the Select Committee should receive the next update at its meeting on 4 July 2018 and that this should include further detail on Phase 3 of the project as well as information on plans for the consultation process including timescales for completion and accessibility of services.

Recommendations:

The Adults and Health Select Committee:

1. noted progress and proposals to date to achieve improved hospital facilities for people who are mentally unwell; and

2. agreed to receives a further update on the development of mental health patient in services at its meeting on 4 July 2018 including details on Phase 3 plans and the consultation process with timescales for completion and accessibility of services.