Agenda item

Ivan McConnell (Executive Director of Commercial Development and Transformation, KMPT) and Hazel Carpenter (Accountable Officer, NHS South Kent Coast CCG and NHS Thanet CCG) were in attendance for this item.

(1)       The Chairman welcomed the guests to the Committee. Ms Carpenter began by explaining that the proposed closure of Davidson Ward was a positive change which she felt had not been conveyed in the submitted paper. She stated that the Davidson ward was one of two wards located in the St Martin’s building which was an old asylum building and the suitability of the building in providing appropriate care had been questioned by the CQC; it was not best practice for patients to be treated in its current setting. The ward was a ten bedded rehabilitation ward but only had five occupants and did not provide acute care. She noted that KMPT had increased the number of community rehabilitation beds through the provision of nine beds in supported housing. She reported that there was an opportunity to invest the £10 million in community rehabilitation services, which was currently spent in out of area placements for patients in East Kent, by repatriating them to the county; eight patients from Thanet have already been identified to return locally.

(2)       Mr McConnell explained that Davidson Ward was not fit for purpose and had been heavily criticised by the CQC. It was not a suitable facility for patients to undertake rehabilitation as it did not have access facilities and the Trust was unable to recruit staff to the ward. He highlighted that the guidelines stated that community rehabilitation should take place in the local community with intensive support.  He noted that there were two types of rehabilitation: services provided in the community and intensive services for post-acute discharge which were provided in three units in East Kent which were highly acclaimed.

(3)       A Member enquired about engagement with partners about supported housing and out of area placements. Mr McConnell stated that nine beds in supported housing had been created which would help to mitigate the closure of the 10 bedded Davidson Ward. He noted the importance of working with partners including borough and district councils with regards to social housing and undertook to work more collaboratively with them. Mr McConnell explained that seven patients from Thanet who received intensive rehabilitation out-of-area cost £951,208 a year in locations as far away as Manchester and Newcastle; if all out-of-area patients in East Kent were repatriated and they could be treated nearer to home and £10 million would be saved which would be used to invest in local rehabilitation services.

(4)       A number of comments were made about staffing. Mr McConnell explained that rehabilitation services did not always need to be undertaken by social workers and mental health professionals; a whole range of alternative staffing could be used such as peer support workers to provide support in the community. He reported the need to look at alternative models of staffing and highlighted the work of some housing providers in London who were training apprentices to become support workers. Mr McConnell stated that traditional models of care over medicalised staffing; the Trust had introduced a therapeutic staffing model which had nursing cover supported by occupational therapists; art, drama and music therapists; and psychologists to assist with the patient’s recovery.  He noted that the Trust had successfully been able to recruit assistant psychologists, as there were a large number of people with psychology degrees in Kent & Medway, to support rehabilitation services. 

(5)       A Member requested if it would be possible for the Committee to visit some of the units. Mr McConnell stated that he would be happy to facilitate a visit, but requested that there was a maximum of three people for a visit to an inpatient ward as it was disruptive to the ward; he noted that he would welcome the Members’ feedback. Mr Inett noted that Healthwatch Kent had undertaken a Enter & View visit and they found that it had been a positive experience for patients; the reports were available on Healthwatch Kent’s website.

(6)       Mr Inett enquired about engagement with service users and careers. Mr McConnell reported that all existing service users and those who provided rehabilitation support had been engaged in dialogue with the CCG and Trust.

(7)       RESOLVED that:

(a)       the Committee does not deem the redesign of mental health rehabilitation services in East Kent to be a substantial variation of service.

(b)       East Kent CCGs and KMPT be invited to submit a report to the Committee in six months.