Agenda item

In attendance for this item: Nina Marshall (Interim Programme Director Adult Eating Disorder Provider Collaborative /CAMHS Inpatient Kent and Sussex, Sussex Partnership NHS Foundation Trust) and Gill Burns (Children’s Services Director, NELFT)

1.         The Chair welcomed the guests and invited them to highlight any changes since the report was prepared. Ms Marshall highlighted that the additional beds at Kent & Medway Adolescent Hospital (KMAH) had been completed and would come into use the next week following sign off.

2.         A Member asked why the provision of beds appeared to have changed over time. Ms Burns explained that initial plans had been agreed pre-covid and there had been a fundamental change in the environment since then. There had also been a significant delay with building works due to availability of specialist materials.

3.         In summary, NELFT had been commissioned to provide 11 beds at KMAH which would all be operational the following week. The Trust then agreed to provide another 3 beds designated for eating disorders, making a total of 14 beds for General Acute/Eating Disorder (GAU/ED). In addition, there would be a phased introduction of 3 short-stay beds (72 hours) and there was already an on-site section 136 bed.

4.         A Member questioned whether the building works had been carried out in line with the original specification and listed some of the repairs that they understood had already been required to the recent renovations. Ms Burns explained that specialist building companies had been used who were experts in refurbishing in-patient wards. Numerous inspections had been carried out to certify the works. Undertaking work to in improve the ward’s environment was an iterative process. In terms of the safety of the curtains/ blinds used in wards, the Trust received a national NHS alert about a potential safety issue and subsequently acted on that information. There was a balance between keeping a therapeutic environment and maintaining a hospital ward.

5.         Asked whether all staff were aware of the Crest service, Ms Burns confirmed that the crisis service had been operating since 2017 though its name had changed last year which may have caused confusion.

6.          A Member asked about the closure of beds at St Mary Cray. Ms Marshall explained they had not been advised which type of beds had closed but they presumed it was the low secure beds at Priory, which were a national resource and required by very few adolescents. Those beds were not within the footprint of the Kent and Surrey provider collaborative but provision was available from the neighbouring Sussex Partnership if required.

7.         The 17 commissioned beds within Kent were determined by local need and were to be seen in the wider context of investment in rapid home response services to try and keep young people close to home and out of inpatient care. Specialist beds outside of the local footprint would always be required as a shared resource as there was not enough local demand for these.

8.         Asked about the accessibility of the eating disorder unit at Hayward’s Heath, Ms Marshall confirmed it was accessible by public transport though there was a change involved. However, most local young people accessed services at KMAH.

9.         Discussing local care, a Member noted that psychiatric adolescent support was often viewed on a national basis. For example, if someone required intensive psychiatric care, they might go to a Psychiatric Intensive Care Unit (PICU) located in Sheffield because there were no such facilities in Kent. The Member felt there was a national issue of underfunding in the area of psychiatric care.

10.      Asked for clarity about the maximum age of young people accessing services at the KMAH, Ms Marshall explained that adolescents between 12 and 18 could access the service but the restriction on 18 would be waived if the individual could finish their treatment in a timely manner without the need to transfer to an adult facility. Under 13s accessed a national resource. Ms Burns added that no patient would be discharged without an arrangement in place, and if transfer to an adult setting was required the two teams would work closely together for a smooth transition. In Kent there was a jointly funded post dedicated to such transitions.

11.      Data monitoring showed a sharp increase in Kent referrals to the rapid response team. Ms Marshall explained that whilst that spike had been specific to Kent, that number had been reducing (whereas other areas nationally were increasing). The decrease was linked to reduced demand, but also reflected system wide collaboration and the introduction of various initiatives.

12.      The Chair requested that the guests provide an update once the funding for the Psychiatric Intensive Care Unit (PICU) in Kent and Sussex had been resolved. He understood that NHS England had funded the revenue but the Kent & Medway and Sussex ICS’s had yet to approve the capital. He offered the Committee’s help in managing that situation, if required.

13.      He also requested that the committee be provided with a written update once the posts of family ambassador and trust liaison nurse had been recruited to.

14.      RESOLVED that:

i)          the update be noted;

ii)         the NHS attend for a further update once capital funding for the proposed Psychiatric Intensive Care Unit (PICU) in Kent and Sussex has been resolved;

iii)        the NHS provide a written update once the posts of family ambassador and trust liaison nurse have been recruited to.