Agenda item

Ivan McConnell (Director of Transformation and Commercial Development, Kent and Medway NHS and Social Care Partnership Trust), Angela McNab (Chief Executive, Kent and Medway NHS and Social Care Partnership Trust) and Ian Ayres (Accountable Officer, NHS West Kent CCG) were in attendance for this item.

(1)       The Chairman welcomed the Committee’s guests and asked them to introduce the item.

(2)       Ms McNab updated the Committee on the progress of the plan following the conclusion of the Kent and Medway NHS Joint Health Overview and Scrutiny Committee (JHOSC). She reminded Members that Medway Council’s Health and Adult Social Care Overview and Scrutiny Committee had subsequently referred the decision to the Secretary of State for Health. After an initial assessment by the Independent Reconfiguration Panel, the Secretary of State confirmed that the reconfiguration could proceed.

(3)       Kent and Medway NHS and Social Care Partnership Trust (KMPT) had continued to move forward with implementation of the plan. One new ward had been opened at the Dartford Centre of Excellence site which had enabled the closure of the younger adults ward at Medway Maritime Hospital before Christmas. The remaining ward at Medway Maritime Hospital was to close as soon as possible once the additional bed capacity in Kent and Medway had been increased. The new ward in Dartford provided better facilities for patients including private bath rooms. Enhanced transport support had been provided for relatives and friends over the holiday period. KMPT had met regularly with service users during these changes and had received positive feedback. In addition, KMPT were recruiting to the enhanced Home Treatment and Crisis Teams. A key aim of KMPT was to reduce the use of crisis wards over time with improved community and home services; enhanced psychiatric liaison and street triage teams with Kent Police.

(4)       In November, KMPT began piloting a new personality disorder service in Medway. If successful, they planned to role out the intensive day service across Kent and Medway. The outcome of the pilot was already looking very positive. 15 patients had been involved in the pilot; these patients had historically had multiple presentations leading to Section 136 or acute admissions. Since the beginning of the pilot, only one patient has had a presentation.

(5)       KMPT were developing plans to enhance the number of beds with the introduction of 14 additional beds across Kent and Medway. The KMPT Board had agreed the capital spend to facilitate additional bed capacity at the Maidstone site. Discussions were taking place with regards to a capital build (new build) or a modular build to facilitate the additional beds.  KMPT would shortly be starting the refurbishment of Dudley Venables House in Canterbury which would increase acute care and improve accommodation. This facility was due to re-open in June or July.

(6)       KMPT were working with service users and carers to clearly define the term Centre of Excellence. They were looking at the range of professionals and interventions that service users would have access to at all Centres of Excellence.

(7)       Members of the Committee then proceeded to ask a series of questions and made a number of comments. A number of Members enquired about the number of beds and additional capacity. KMPT explained that they currently provided 160 acute beds. Public Health had assessed the need for acute beds in Kent and Medway and revised the figure to 174 acute beds. KMPT were looking to increase capacity by 14 acute beds through the development of a new unit in Maidstone. These figures did not include forensic or hostel beds.

(8)       A series of questions were asked about the street triage pilot with Kent Police. The initial twelve week pilot has been extended until the end of March. The pilot had been of great benefit with joint learning and increased Police confidence. However the current project was not scalable; KMPT were looking to identify a sustainable model for the whole of Kent. KMPT were looking to introduce a single number for the Police to contact to access the appropriate local mental health team when they come across a person presenting with mental health symptoms. If the person is known to the local team, the team would be able to give advice and guidance directly to the Police Officer.

(9)       One Member commented about the provision of services for older adults. Ms McNab explained that services for older people were reconfigured last year which included the closure of a ward at William Harvey Hospital. KMPT were developing a plan to further improve older peoples services.

(10)     A number of questions were asked about preventative services and early intervention. As part of their Transformation Programme, KMPT explained they were increasing engagement with GPs to support early intervention through primary care, in order to prevent an escalation in the patient’s needs. For patients with an acute need, they would go to their closest Centre of Excellence in Canterbury, Dartford or Maidstone which would have consultant cover seven days a week. For patients who were not in crisis but had a secondary need, KMPT would be developing community hubs to deliver a range of services locally.

(11)     Clarification of what was meant in practise by the introduction of seven days a week consultant cover. KMPT explained that they were looking to move step by step towards seven days a week consultant cover. They would not provide 24/7 cover instead they would identify key times of the day when consultant interventions were required.

(12)     One Member expressed concern at KMPT’s ability to finance and maintain facilities at the Centre of Excellence. Ms McNab explained that she had no concerns about funding of those facilities. Another Member enquired about services available in Sheerness. Ms McNab explained that she would write to the Member detailing the services available in Sheerness. Questions were also asked about transition and integrated multidisciplinary teams.

(13)     Members made a number of comments about the format of the report. It was suggested that in future information could be presented in the form of a map so that Members can assess the provision of services across Kent.  Ms McNab agreed to take this idea forward and make the figures more visible in their next report.

(14)     RESOLVED That the Committee thanks its guests, notes the good progress made and looks forward to a written update within six months.