Agenda item

(To receive a report from Jane Marshall, Director of Strategy, Lincolnshire Partnership NHS Foundation Trust, which provides the Committee with an update on how Lincolnshire Partnership NHS Foundation Trust through its clinical teams is currently testing a new service development to introduce a Home Treatment Team for Older Adults, accessing functional mental health care)

The Chairman highlighted to the Committee that information pertaining to this item could be found on pages 37 to 40 of the report pack.

The Chairman advised that there were three contributors for this item: Jane Marshall, Director of Strategy, Lincolnshire Partnership NHS Foundation Trust, Deborah Hussey, Quality Improvement and Assurance Lead for Specialist Services, Lincolnshire Partnership NHS Foundation Trust and Steve Roberts, Associate Director of Operations, Older Adult Services, Lincolnshire Partnership NHS Foundation Trust.

The Associate Director of Operations, Older Adult Services, Lincolnshire Partnership NHS Foundation Trust presented the report and made reference to the Older People Home Treatment Team Outcomes as detailed on pages 38 to 40 of the report pack.  It was highlighted the model had reduced in-patient admissions and the number of patients treated out of area; it had also provided improved treatment efficiency; improved patient wellbeing; reduced clinical incidents; and reduced medication use.

The Committee was advised that the Older People Home Treatment Team pilot over the last 18 months had proven to be successful across all performance, financial and quality indicators.  It was highlighted that a process of consultation (or targeted engagement) was now required in order to consider the Home Treatment model as a permanent arrangement taking into account staff, carer, patients and stakeholder views.

During discussion, the Committee made the following comments:

·               Need for the service – The Committee noted that it was difficult to foresee need going forward, but it was anticipated that need would increase.  It was highlighted that the service was not standalone; and that a continuous care pathway in mental health had been set up, It was noted further that a single point for decision making had been introduced across the pathway, to help decisions to be made in a timely manner;

·               Joint working – The Committee was advised that the service worked with a network of services and providers across the county;

·               Positive effects of Covid-19 -  It was noted that there had been positives from the pandemic, one in particular was that of community engagement; and the need to try to perpetuate some of the enthusiasm going forward,  as part of the universal offer;

·               Older Adult Home Service Treatment Service and the definition of Age for Older. The Committee was advised that the Home Treatment Team dealt with the most acute patients, who did not need to be in hospital; and that contact through the pandemic had continued to be face to face.  It was noted that the other mental health teams, had experienced a reduction in demand; and the service looked at alternative ways to being able to provide the service required.  As mentioned earlier in the item a digital offer was made, as was telephone calling; all patients were monitored and received contact.  Clarification was given that for dementia there was no age limit and that the term older age had traditionally referred to someone 65 and above, but services were largely offered irrespective of age;

·               Ward Provision – Confirmation was given that only one ward was necessary as the need was no longer there. Since the commencement of the model, of the 394 referrals only 28 of the patients had required progression to in-patient admission.  This had represented a potential admission avoidance  of circa 93% (366 patients avoided admission);

·               Positive feedback – The Committee was advised that overall, patient experience of the model had been consistently high and that this information could be shared with the Committee; and

·               When targeted engagement or consultation was likely to take place.  Reassurance was given that the Trust would seek the views of staff, carers, patients and stakeholders and that the Trust would be commencing targeted engagement or consultation as soon as it could. The Committee noted that Rochford Ward was temporally closed to fund the Older Adult Home Treatment Service; and that the Trust was happy to commence targeted engagement or consultation, if the Health Scrutiny Committee was in agreement.  It was confirmed that the Committee was in agreement with this approach.

The Chairman on behalf of the Committee extended thanks to the contributors for the first three items on the agenda.

RESOLVED

That the progress made with the older adult's home treatment service be noted; and that an item on the targeted engagement/consultation be considered a future meeting of the Committee.