Agenda item

(To receive a report from Lincolnshire Partnership NHS Foundation Trust, which invites the Committee to comment on the pilot Intensive Home Treatment Service which commenced operating on 4 November 2019.  Senior representatives from the Lincolnshire Partnership NHS Foundation Trust will be in attendance for this item)

The Committee gave consideration to a report from Lincolnshire Partnership NHS Foundation Trust (LPFT), which invited comments on the Intensive Home Treatment Service Pilot, which had commenced operation on 4 November 2019.

The Chairman welcomed to the meeting Jane Marshall, Director of Strategy, Lincolnshire Partnership NHS Foundation Trust, Rachel Redgrave, Head of Commissioning for Mental Health, South West Lincolnshire Clinical Commissioning Group and Anita Lewin, Director of Nursing, Allied Health Professionals and Quality.

The Committee was advised that the pilot provided a community Intensive Home Treatment service for young people (aged up to 18).  It was noted that investment for the new model of care pilot (including the clinical team running it) had come from an existing inpatient service (based at Ash Villa in Sleaford), which was temporarily closed.  It was noted further that if the pilot was successful, following evaluation there was an option to continue with it. The Committee was advised that as the proposal would be a significant service change, it would be subject to public engagement and public consultation in line with statutory duties.

Background details and an explanation of the service was shown on pages 58 and 59 of the report.

The Committee noted that the reason for the pilot was to improve the quality of care provided for young people closer to home. The Committee noted further that the quality treatment and care would be delivered in less restrictive settings as a safe and effective alternative treatment model to in-patient care for young people who would otherwise require admission.

It was highlighted that the aim of the new model was to intervene earlier in the deterioration of a young person's mental health and provide a rapid response with treatment at home in order to prevent admission to hospital.

The Committee noted that whilst staff always provided excellent clinical care, Ash Villa had been identified as a "fragile service" and reasons for that were shown on page 60 of the report, but they included patient safety, the high risk building environment and the financial costs.  The Committee was advised that a decision had been taken in September 2019, to temporarily close the unit on grounds of patient safety.  Approval was given from NHS England to bring forward the pilot, which began on 4 November 2019, with the experienced staff from Ash Villa running the Intensive Home Treatment service.

A timetable for the new model of care was shown on page 61 of the report presented.

In conclusion, the Committee noted that the Lincolnshire Partnership NHS Foundation Trust was committed to a vision of providing care as close as possible to people's homes; and exploring new ways of working to build up capacity in community teams to provide 24/7 community services for young people with mental health problems.  The Committee noted further that improvements were also needed to be made to improve the quality of care provided to young people, which included improving the physical environment of wards that LPFT operated in order to protect patient dignity and privacy as they received care and treatment.

During discussion, the Committee raised the following points:-

·         The Committee's attention was brought to the letter from Brendan Hayes, Chief Executive of LPFT to Debbie Barnes, Chief Executive  Lincolnshire County Council, which had been attached at Appendix A to the Chairman's Supplementary announcements concerning Ash Villa;

·         The refreshing nature of the Pilot, which would bring a better service for young people with mental health issues within their communities;

·         How children and young people with high level needs would be accommodated.  The Committee was advised that LPFT was working closely with the County Council and Child and Adolescent Mental Health Services (CAMHS).  The Committee was advised that earlier intervention would help alleviate young people being accommodated out of county.  The Committee was advised that Ash Villa as a building would not be re-opening and that the County Council was looking at ways to provide the right level of education.  Confirmation was given that there had always been young people accommodated in out of county facilities, as a result of their needs and this would not change.  The Committee noted that LPFT were working together as part of the East Midlands group looking at inpatient provision, which would be completed at the end of October 2020, by which time the community model would have been evaluated.  Some concern was expressed to potential transport issues, should a young person have to go out of county. The Committee asked for information as to how families and carers of children who were admitted as inpatients to an out-of–county CAMHS unit would be supported, given the travelling distance likely to be involved.  Reassurance was given that all organisations were working very closely together to get the best outcomes for young people with mental health issues;

·         Accessibility to the crisis team – The Committee noted that the crisis team provided 24/7 cover for young people up to the age of 18.  It was noted that the service could be accessed by ringing 111; and single point of access could be made through GPs;

·         Educational provision at Ash Villa – It was reported that Ash Villa had not been the sole educator of inpatients at Ash Villa; and when young people were well enough, they had attended mainstream school.  The Committee noted that only a very small minority of young people accessed the school at Ash Villa; and

·         A request was made for the Committee to receive summary information relating to the feedback from service users; and also other options to be considered should the Pilot Intensive Treatment Service prove not to be successful.

The Chairman extended thanks on behalf of the Committee to the representatives from LPFT for their update.

RESOLVED

1.    That LPFT be requested to provide the following information to a future meeting of the Health Scrutiny Committee for Lincolnshire:

·         other options, should the pilot Intensive Home Treatment Service not be considered a success; and

·         how families and carers of those children who are admitted as inpatients to an out-of-county CAMHS unit can be supported, given the travel which is likely to be involved.

2.    That LPFT be requested to provide the Committee with a summary of the feedback information received from service users to date.