Agenda item

In attendance: Adam Wickings (Deputy Managing Director, West Kent CCG), Janet Manuel (Clinical Head Specialist Assessments and Placements Team, DGS, Medway & Swale CCG) and Andy Lang (Lead Nurse for Continuing Healthcare, NEL).

1.    The Chair welcomed the guests and referenced the informal briefing for HOSC Members that had taken place a few weeks previously.

2.    Mr Wickings referred to a wider piece of work around developing a clear clinical model for patients with complex dementia, including quantifying future demand.

3.    In terms of the Frank Lloyd Unit, he explained that affected patients had been supported by Continuing Health Care to find a suitable alternative placement. There were currently no patients in the Unit.

4.    Ms Manuel explained that North Kent CCGs had assisted in the repatriation of five former Frank Lloyd patients. That unit had never been intended for long-term stays. By supporting and engaging partners, they were able to find suitable placements for each of the five patients.

5.    Mr Lang confirmed NEL had assisted in repatriating four Frank Lloyd patients. They were able to do this by looking for suitable placements as well as working alongside the patients and their families.

6.    Mr Bowles stated that nothing he had heard from the CCG over the course of the previous two years had convinced him that closing the unit was the right thing to do at that time.

7.    A proposal from Mr Bowles was moved and seconded by Mr Wright:

The Committee is asked to agree to refer the closure of the Frank Lloyd unit to the Secretary of State on the grounds that it was not in the interests of the local population.

8.    The Chair explained that the Committee were unable to refer the item at this meeting because Members were required by law to set out their concerns and give the CCG adequate time to consider and respond to those concerns. Members were informed that the motion proposed would therefore not be valid in this form.

9.    Members had the following concerns around the de-commissioning of the Frank Lloyd Unit:

a.    the new care model for complex dementia patients had not been fully developed nor implemented;

b.    it was unclear if there was suitable, alternative local provision for those with complex dementia. Whilst Members agreed care within the home was appropriate for some, they felt there would always be a small number requiring dedicated facilities;

c.    the proposed care model had dementia patients supported within existing care homes, but it was unclear if those care homes were ready or had the right staff to deal with complex behaviour;

d.    there had been a lack of openness around the closure of the Frank Lloyd unit, which Members understood had not been accepting referrals for a substantial period;

e.    there had not been suitable clinical evidence that the closure of the Unit was in the interests of the local population; and

f.     it was unclear what would happen to the staff employed at Frank Lloyd, but Members felt there was a real risk their professional skills would be lost.

10. In relation to point 9d, Mr Wickings responded that the Unit was empty, not closed, and the CCG were committed to reopening the beds if there was a future need to do so.

11. Following their discussion, the Chair proposed the following motion:

That this Committee considers that the decision of the Kent & Medway CCGs to de-commission the Frank Lloyd Unit will not be in the best interests of the local population for the following reasons:

a)           The decision to close was premature without sufficient alternate provision being available in Kent and Medway.

b)           Insufficient consultation had been carried out.

c)            There was a lack of proper clinical evidence that the closure was in the best interests of patients.

d)           There would be workforce implications that needed to be taken into account in light of the closure.

Therefore the Committee asks that the Kent & Medway CCGs consider and respond to these comments and report these back to the Committee ahead of a final determination as to whether or not to refer their decision to the Secretary of State on the grounds that the proposal is not considered to be in the best interests of the health service in the area.

12. The recommendation was agreed.

13. RESOLVED that this Committee considers that the decision of the Kent & Medway CCGs to de-commission the Frank Lloyd Unit will not be in the best interests of the local population for the following reasons:

a)                The decision to close was premature without sufficient alternate provision being available in Kent and Medway.

b)                Insufficient consultation had been carried out.

c)                 There was a lack of proper clinical evidence that the closure was in the best interests of patients.

d)                There would be workforce implications that needed to be taken into account in light of the closure.

Therefore the Committee asks that the Kent & Medway CCGs consider and respond to these comments and report these back to the Committee ahead of a final determination as to whether or not to refer their decision to the Secretary of State on the grounds that the proposal is not considered to be in the best interests of the health service in the area.