Agenda item

Evelyn White (Associate Director Integrated Commissioning, NHS Kent and Medway), Linda Caldwell ( Senior Commissioning Manager Carers and Older People East Kent, NHS Kent and Medway), Dr Kanagasooriam (GP Commissioning Lead for Older Peoples Mental Health), Dr Karen White (Executive Medical Director), Dr Barbara Beats (Assistant Medical Director – Older Adults), Justine Leonard (OPMHN and Specialist Service Line Director, KMP), Su Brown  (Head of Operations, Communications and Engagement, NHS Kent and Medway) were in attendance for this item.

(1)       The Chairman welcomed Health Service colleagues and invited them to introduce their preliminary paper on Older Persons Mental Health Services in East Kent.

(2)       Ms White presented the paper which set out the outcomes of the formal consultation which would be presented to the NHS Kent and Medway Board in later in the month. Ms White confirmed that the Trust were part of a bid for national funding to make the implementation of improvements faster for those with dementia, this was an important work stream and there was partnership working with social care colleagues in relation to this important piece of work.  The Trust was aware of the recommendations of the KCC Select Committee on Dementia.

(3)       Ms Leonard confirmed that there were two options for the proposed provision at St Martins, these were either to build a new unit or to convert an existing facility but this would not be a ward in the older part of the hospital.

(4)       Ms White explained that one of the pieces of work that was going on across the County was to ensure that support staff see the individual and not the dementia. There were dementia champions at each of the Acute Trusts. This was not part of the process being reported to the Committee today but was part of a wider agenda.

(5)       In response to the reference to the patient safety aspect of the options, Dr White explained that option one would mean it was necessary to rota across three sites and it would be more likely that locum staff would need to be used.  Whereas with option two, it would only be necessary to have a rota across two sites which would be easier to cover with Trust staff.

(6)       In relation to a question on the increased prevalence of dementia within an aging population and the proposals ability to cope with this, Dr White stated that an increase in the number of people with dementia did not necessary mean that there was a need for an increased number of inpatient beds, what was needed was support in the community to enable better management of the condition and improved individual care in the persons own home. There should be more investment in crisis treatment and care in the community which would result in a reduced need for acute beds.  There was a need to work closely with local authority colleagues to provide a joined up service and to be confident that the commissioning of beds met the needs now and in the immediate future.  She emphasised that it was essential to build capacity in the community prior to the any planned reduction in acute beds. Ms White confirmed that there was a dedicated dementia crisis team.

(7)       In relation to the demographic changes of an elderly population, Dr Betts stated that the proposal should provide sufficient flexibility to meet a wide range of needs alongside adequate community support and early discharge planning in to a supported home environment. Specifically, the importance of the proposals taking account of the older population who move into the Thanet coastal area was noted as one demographic factor.

(8)       Regarding a question on mixed sex wards, Ms Leonard stated that the aim of the new provision was to provide single en-suite rooms with good access to a social space and a female only lounge. There will be mixed facilities which was normal in residential care facilities and they would do everything to cater for the individual and to protect privacy.

(9)       Regarding respite provision, Ms White explained that this was an important element of their plan and was one of a number of things that they were working on with colleagues in social care on as part of their dementia plan.  

(10)     In response to a question on why there were no public consultation meetings held in Thanet Ms White explained that the three consultation meetings had been spread across the whole area based on advice from their communications and engagement team.  In addition to these meetings there was also a lot of work carried out with groups that support older people with Dementia and Mental Health needs across this area, such as Age UK and via the Dementia cafes.

(11)     Ms White stated that the Trust was in discussion with Kent Community Health Trust regarding integrated teams and this was part of a whole system approach to the service.

(12)     Responding to a specific question about what issues existed around recruiting clinical staff, Dr White stated that there had always been an issue with attracting doctors into the area of psychiatry, especially focusing on older people with dementia; it had a stigma and therefore healthcare professionals were less likely to select to work in this area. However, the Trust had been more successful than other areas in attracting staff and offered placements to doctors before they made their final choice of specialism so that they could do this based on a positive experience.  She asked Members to do all that they could to reduce the stigma attached to Mental Illness.

(13)     RESOLVED that the Committee support the Older People’s Mental Health inpatient reconfiguration based on option 2.