Agenda item

Purpose of the Report:

To summarise what Healthwatch Surrey is hearing and doing in relation to mental health services. It also makes a recommendation about how the committee and Healthwatch Surrey might work together on this topic in the future.

Declarations of Interests:

A non-pecuniary interest was declared by Bill Chapman who advised that he was a Governor of Surrey and Borders Partnership NHS Foundation Trust.

Witnesses:

Tumi Banda, Associate Director for Working Age Adult Inpatient Services, Surrey and Borders Partnership NHS, Foundation Trust

Matthew Parris, Deputy CEO, Healthwatch Surrey

Lorna Payne, Chief Operating Officer, Surrey and Borders Partnership NHS Foundation Trust

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

Key points raised during the discussion:

1.     The Committee received an introduction on the role of Healthwatch Surrey (HWSy) within the health and social care system in the County. Members heard that Healthwatch used various methods to gain insights into patient experiences around the delivery of specific services making recommendations to commissioners and providers in response to these.

2.     Further information was also provided on the Enter and View visit to the Abraham Cowley Unit (ACU), a mental health inpatient unit operated by Surrey and Borders Partnership NHS Foundation Trust. The Committee heard the reasons behind HWSy’s decision to invoke its statutory power to undertake an Enter and View visit at the unit and were informed of the methodology used and engagement conducted by HWSy to collect evidence during their visits. SABP had been very responsive in seeking to address the problems identified by HWSy officers during their visit but that there appeared to be some long-term challenges that it was necessary for the Trust to address regarding its inpatient provision. The Committee was informed that staffing levels and the environment were the two key challenges at the ACU.

3.     Representatives from SABP were given the opportunity to respond to the findings of the Enter and View Report. It was acknowledged that the capacity to recruit and retain good quality nursing staff as well as the environment created significant challenges for the provision of inpatient care at the ACU. Members heard that plans were being developed to improve the quality of the environment in working age adult wards through rebuilding and refurbishment alongside a building programme to improve inpatient mental health service units across the county. The Committee was advised that SABP had commissioned an independent review to make recommendations on how the Trust could improve patient experiences at the ACU.

4.     Discussions turned to the use of dormitories to house patients at the ACU and the Committee was advised that many patients had reported that sleeping in dormitories had impacted negatively on them. Members of the Committee requested that SABP commit to a clear timescale on when dormitories would be replaced with single occupancy rooms. Representatives from SABP acknowledged that dormitories were not optimum for accommodating mental health inpatients but stressed that the sums associated with refurbishing the ACU were significant. The Trust was progressing its plans to have three mental health inpatient hospitals in Surrey but already had funding in place to refurbish the ACU irrespective of whether they received financial backing for the three hospital solution. Members were advised that, when taking demand into account, SABP’s inpatient services were currently over 100% occupancy and that a plan was needed to build some capacity within the Trust’s existing provision to allow the refurbishment work to commence.

5.     Discussions turned to the significant number of negative experiences recorded by HWSy from among those who had used mental health inpatient services in Surrey. Representatives from SABP informed the Committee that the majority of those who used mental health inpatient services were there involuntarily having been sectioned under the Mental Health Act. As such, their experiences would necessarily be less positive when compared to those who use other types of healthcare services such as Primary Care. Representatives from SABP confirmed that the Trust also recorded patient experience and used this feedback to inform and improve their services which had led to improvements in mental health inpatient provision over recent years.

6.     Members discussed funding for mental health services in Surrey highlighting that less was spent per head in the County than in many other local authority areas. The Committee highlighted the need to lobby Government to ensure that Surrey got a fair deal from allocations that had been made available by the Department of Health and Social Care in order to establish parity of esteem with physical health. It was agreed that the Committee should write to the Secretary of State for Health and Social Care regarding the availability of funding for mental health services in Surrey.

7.     Conversations took place regarding specific actions that the Committee could hold SABP accountable against for improving the experience of those who used inpatient mental health services in Surrey. Members heard that the Trust had produced an Improvement Plan in response to the Care Quality Commission report on the ACU which the Committee could use to hold SABP account for its performance. It was agreed that the Improvement Plan would be circulated to the Committee for this purpose.

Actions/further information to be provided:

1.     SABP Improvement Plan in response to CQC inspection report on the Abraham Cowley Unit to be circulated to the Committee.

RESOLVED:

That the Health Integration and Commissioning Select Committee:

       i.          recognises that mental health provision is comprised of various service areas including prevention, resilience, CAMHS, community and inpatient services. The Committee restated its commitment to conduct ongoing scrutiny of mental health provision in Surrey, in particular through direct engagement with service users, commissioners and providers, for review at its March meeting;

2. restates its commitment to conduct ongoing scrutiny of mental health provision in Surrey, in particular through direct engagement with service users, commissioners and providers, for review at its March meeting; and

3. considers the key points raised and recommendations made at the Adult and Health Select Committee meeting of 9 November 2017 when planning further scrutiny of inpatient mental health services, in particular reviewing how performance is assessed from the patients’ perspective.