Agenda item

(To receive a report from the Lincolnshire Partnership NHS Foundation Trust, which invites the Committee to comment on the proposal to continue the Older Adult Home Treatment Team service as well a re-opening the refurbished Brant Ward in Lincoln.  Senior representatives from the Lincolnshire Partnership NHS Foundation Trust will be in attendance for this item)  

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 need for older mental health services was increasing; and that there were some gaps in services.  The ambition of the pilot was to increase community support; offer care closer to home; to deliver seven day a week services; and have hospital care available to the best standard when needed.

The Committee was reminded that the Trust had set up the Adult Home Treatment Team (HTT) as a pilot service whilst estates work had been undertaken to upgrade Brant Ward, Lincoln to meet modern NHS privacy and dignity standards.  The HTT provided services to adults with functional mental health conditions for example someone living with anxiety or depression.  The service was focussed on admission avoidance, and supporting early discharge from hospital.

At the Health Scrutiny Committee for Lincolnshire meeting held in April 2019, a report had been received relating to the first five months of operation of the Home Treatment Team, which had demonstrated significant positive outcomes, details of which were shown on page 64 of the report.

The Committee was advised that the upgrade to Brant Ward at Witham Court, Lincoln to create single en-suite bedrooms and improve ward living spaces was now complete and ready to re-open.

It was highlighted that LPFT were proposing to continue the current service model with one functional older adult mental health ward (Brant Ward, Lincoln) and a county-wide HTT.  The Committee was advised as a result the Trust was proposing to transfer the in-patient ward from Rochford Ward in Boston to the newly refurbished Brant Ward in Lincoln.  It was highlighted that the reason for the change was that the Rochford Ward was not fit for purpose and it did not meet the Care Quality Commission standard for care environments.

It was reported that the Rochford Ward would be temporarily closed with staff working into the HTT model or in other services.  The Committee noted that a further HTT hub would be created in Boston to accommodate the HTT team.

In conclusion, the Committee was advised that LPFT were committed to a vision of providing care as close as possible to people's homes.  There was recognition that there were still some challenging decisions to be made on the balance of inpatient and community facing services.

The Committee were invited to provide feedback to LPFT on the proposal to continue Older Adult Home Treatment service as well as re-opening of the refurbished Brant Ward, Lincoln.

During consideration of this item, the Committee raised the following points:-

·         Support overall was given to the HTT service, and the Committee welcomed further details concerning the outcomes of the evaluation of the HTT service;

·         Some concern was expressed to the temporary loss of the Rochford Ward. Reassurance was given that the Trust was committed to having a presence in Boston with ward 12; and at the moment it was difficult to ascertain how much provision was required. Members of the Committee were invited to visit both the Rochford Ward, Pilgrim Hospital, Boston and Brant Ward, Lincoln;

·         The need to consider transportation for patients from Boston to Brant Ward, Lincoln.  The Committee was advised that the County Council was looking into transport issues within the county with the CCG;  

·         Nurse presence in the police control – The Committee noted that a nurse was present on the control room to help deal with mental health issues earlier on in the process; and to mobilise the crisis team.  The Committee noted further that the crisis nurse service was 24/7 and that it was hoped to expand this service further;

·         How many patients since October 2018 had been treated by the HTT. Representatives present agreed to provide the requested data;

·         One member asked what the positive outcomes had been.  The Committee was advised that there had been a reduction in the number of inpatients; and patients that had been sent out-of-county for in-patient treatment;

·         Referrals to the service – The Committee was advised that referrals could be made by using 111; by health professionals; mental health teams; and Home Treatment teams;

·         Evaluation data – The Committee was advised that in April 2020, the pilot would have been in operation for 18 months; and it was felt that there would be enough data to present to the Committee after the April 2020 date;

·         Whether the Trust was actively seeking capital funding to move and re-open the provision at Pilgrim; and whether funding had been secured to continue the older adult home treatment.  The Committee was advised that the Rochford Ward was not fit for purpose; once evaluation of the HTT was completed, the CCG would be approached for funding, hopefully to include the HTT; and

·         A request was made for feedback of the comments received from patients and carers to date with regard to the new service and the temporary closure of the Rochford Ward.  The Committee was advised that this information would be made available to the Committee.

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

RESOLVED

1.    That LPFT be requested to report to a future meeting of the Health Scrutiny Committee for Lincolnshire on the outcome of the evaluation of the Home Treatment Team pilot.

2.     That an invitation for members of the Committee to visit both Rochford Ward, Pilgrim Hospital, Boston and Brant Ward, County Hospital, Lincoln be noted.

3.    That LPFT be requested to provide information to the Health Scrutiny Committee for Lincolnshire on the following:

·         Any feedback to date from service users on the temporary closure of Rochford Ward and the Home Treatment Team arrangements; and

·         The number of patients to date who have been treated by the Home Treatment Team since October 2018, including the number of patients who have avoided an in-patient admission.