Agenda item

Attending for this Item were:

Herefordshire and Worcestershire Health and Care NHS Trust (HWHCT)

Sue Harris, Director of Strategy and Partnerships

Jayne Westwood, Service Manager – Older Adult Mental Health

Emma Webber, Associate Director of Specialist Mental Health Services

Herefordshire and Worcestershire Clinical Commissioning Group (HWCCG)

Jenny Dalloway, Lead for Mental Health, Learning Disabilities and Children

Dr Tim Lee, Mental Health GP Lead

Members were reminded that during the COVID-19 pandemic, a number of temporary service changes were made across the NHS to enable health services to be restored.  One such change related to a ward for older adult mental health.  The Athelon Ward at Newtown Hospital, Worcester was temporarily closed when efforts were made to keep older people out of hospital as much as possible and the ward budget was used to introduce a Hospital at Home service as a pilot scheme.

The HWHCT now wished to consult on the proposal to retain the Hospital at Home service provision and permanently close the 14 bed Athelon Ward.  Ward provision for older adult mental health would continue at the established New Haven Unit at the Princess of Wales Community Hospital, Bromsgrove.

During the introduction, main points included:

·         Recruitment to the Hospital at Home service had been very successful and it was fully staffed within 3 months of starting

·         Although the 14 bed Athelon Ward had closed, all Staff were reassigned

·         As a result of the changes made, weekend crisis support was now available and there were dedicated carers workers

·         Continuous feedback had been sought since the introduction of the Hospital at Home service, with patients and relatives appreciating the provision

·         HWHCT was pleased with the very positive results, with more patients being seen and length of stay reduced

·         The reduction of 14 beds from the system had not resulted in any patient being in need of an out of County placement and at the time of the HOSC, 5 beds were empty

·         Members heard that the proposal enhanced patient choice

·         HWHCT had engaged with patients and carers throughout the initiative and had continuously evaluated the feedback.  It was noted that the Equality Impact Assessment would be reviewed

·         Due to the ongoing COVID-19 pandemic, the Trust had no plan to hold a large scale engagement event during the consultation, something which they would have done in the past

·         A Report would be taken to the HWHCT Board and HWCCG in January 2022 for approval

·         The HWCCG was supportive of the proposal which had been considered some years previously, however, it was keen to see further formal consultation before any decision was made

·         Dr Tim Lee reported that the model of care proposed was in place across the world.

Members were invited to ask questions and the main points made included:

·         It was clarified that the loss of 14 beds was for functional mental health in older adults and that no Dementia beds would be lost as a result of the proposal

·         As national COVID-19 rules were relaxed, Clinicians had concerns about carer work/life balance.  Evaluation was undertaken and no concerns were raised

·         There was an opportunity to expand the Hospital at Home service, with up to 4 times daily visits

·         At any one time, the Hospital at Home service could support up to 18 patients and on any one shift, at least 4 staff were available, with at least 3 qualified carers

·         The majority of Staff employed on the Athelon Ward were moved on to other Wards as part of the COVID-19 redeployment programme

·         Recruitment had been successful, partly due to the service being unique within the region.  Up to 6 external candidates had been employed

·         Engagement with carers was undertaken at all levels, whether a relative, young carer, neighbour etc

·         A Member asked whether the Consultation should include the Police, with the Trust agreeing to add West Mercia Police.

The Managing Director of Healthwatch Worcestershire was invited to comment and in doing so acknowledged that service delivery had changed over recent years.

The HOSC Chairman thanked everyone for a useful discussion and gave HOSC support to HWHCT to consult on the Hospital at Home proposal presented.