Agenda item

Vincent Badu (Director of Transformation, Kent and Medway NHS and Social Care Partnership Trust) was in attendance for this item.

(1)          Mr Badu began by stating that the report focussed specifically on the work that the Trust is undertaking to improve the quality of the community mental health teams for younger adults and general activities taking place across the Trust.  Mr Badu wished to acknowledge the Trust’s commitment to providing better services for the community in mental health services.  Services overall were currently rated as ‘good’, but the community mental health teams ‘required improvement.’  To resolve this, caseloads were being reduced.  Services were revisited in January 2018 and teams were inspected over a period of two days.  Concerns related to variability of quality of planning for care and articulation of risks as people presented and how they planned to meet those risks.  As a result, the CQC decided to issue a warning notice because of concerns.  The Trust accepted the findings and were working robustly to make improvements on quality of care and to ensure that patients were safe and receiving care within agreed timeframes, ensuring those waiting have an active review of their needs so that if changes took place the care can be responsive to prevent deterioration.

(2)          One of the key indicators was to receive an assessment of need within 28 days of referral to the secondary mental health service. He reported that at the end of June significant improvements had been made by the three teams visited by the CQC with the highest performing team reaching 93% against a target of 95%.  The lowest performing team was recorded at 62.3%; 20 people had not  received an assessment within the 28-day period.  Mr Badu acknowledged that they were working to improve this and accepted that there was a need to continue to improve.

(3)          Members asked about Section 136 activity and outcomes, partnership working and single point of access.

(4)          Mr Badu stated that overall, there had been a reduction in Section 136 activity.  He explained that at the point when a person had a full mental health act assessment, they were either detained or supported in another way;  less than 50% of people seen converted to formal or informal admission under the Mental Health Act.  Mr Badu noted that that Section 136 was not the best way to support patients.  Work was being done as part of the Crisis Care Concordat  regarding detention.  Mr Badu acknowledged that it was difficult for Police Officers to make assessments and that they are working to bring expertise together for early triage and identifying individuals known to existing services. He noted that Kent Police were able to use a dedicated contact line to speak with mental health practitioners about the available options.

(5)          Members asked about  out of county placements and the single point of access.  Mr Badu reported that whilst no one was currently placed out of area for acute adults or older people’s mental health beds, women who required psychiatric intensive care were placed out of area as there was no local unit or provision in Kent and Medway. 

(6)          In relation to single point of access, he noted that the Trust was committed to ensuring that the services were safe and effective, but had decided that support could be provided in a different way and agreed to restrict the operation of that service. Discussion has taken place with commissioners about reducing the service as activity after 10pm was lower and alternative pathways were in place to provide support. He stated that a 24-hour switchboard service was still available.   He highlighted exploration of the NHS 111 service for lower level support needs, as well as crisis resolution and a review of the home treatment service for complex needs was being conducted.

(7)          Mr Inett informed the Committee that Healthwatch were collating patient experience feedback from various groups and they were meeting with the Trust regarding to share this.

(8)          The Chair asked about the reported improvements to staff supervision and its sustainability.  Mr Badu confirmed that Trust was reviewing if robust supervision trees were put in place and if protected time was given supervision.  Quality of supervision was assured by clinical audit checks which looked at caseload numbers, record keeping, risk assessments and the quality of the offer to patients and relatives.

(9)          The Chair enquired about the Psychiatry Liaison Service.  Mr Badu explained that the Mental Health Five Year Forward View set out the aspirations and requirements for such a service and that work was taking place across Kent and Medway with the CCGs and Acute Trusts to ensure that a service was available to provide the best support across acute care provision.  Mr Badu continued that there might not be a Liaison Service across all sites, but it would be placed where there was a level of need, identified by admissions through A & E.  This would allow services to be provided as quickly and as a swiftly as possible.  Some services would be on a 24-hour basis, with increased support in East Kent, particularly in Queen Elizabeth the Queen Mother Hospital and this would continue to be discussed with partners.  The key challenge is ensuring that the service in place meets the need of the local population but was commissioned to deliver an effective and robust service.

(10)       In conclusion, the Chair welcomed the introduction of the new specialist Mother and Baby Unit in Kent.

(11)       RESOLVED that:

(a)  the Kent and Medway NHS and Social Care Partnership Trust update report be noted;

(b)  the Trust be requested to provide an update to the Committee in six months.