Meeting documents

            Meeting: Health Scrutiny Sub-Committee (County Hall, Durham - Council Chamber - 04/04/2005 10:00:00 AM)

                  Item: A3 (a) Joint Committee - Mental Health Services. (b) South Stanley Centre - Update only. (c) Any other issues from Health Trusts

         

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Health Scrutiny Committee

4 April 2005

Joint Committee - Mental Health Services - Tees and North East Yorkshire Trust

Report of Head of Overview and Scrutiny

Purpose of Report

1. To explain the progress made by the Joint Committee which has been looking at proposals to change mental health provision, particularly in the southern part of Easington.

Background

2. The Sub-Committee is represented on the Joint Committee which has been set up to consider proposed changes in mental health service provision affecting the southern part of Easington. The consultation process refers to the package of proposals as the “Advance” project.

3. A significant number of presentations have been made to the Joint Committee. The general view seems to be that the proposed improvements in facilities in the Tees Valley will be beneficial. The main issues for residents of County Durham appear to relate to:

4. A detailed report is being prepared to set out the views of the Joint Committee. The section relating to County Durham is attached for information.

Recommendation

5. You are asked to note the position and to provide any further comments.

Contact: Ian Mackenzie Tel 0191 3833506




ADVANCE PROPOSALS B ACKGROUND

The Advance Proposals mainly affect the southern part of Easington District although in terms of forensic services the whole of the County is involved.

Easington Primary Care Trust provided a presentation to the Durham Health Scrutiny Sub-Committee during the consultation period. The purpose was to concentrate specifically on the impact on County Durham. The main points which arose were:-
T HE P ATIENTS W HO W ILL BE A FFECTED IN C OUNTY DURHAM AND THE I MPACT
During the period April 2002 to March 2003 there were 513 adult acute admissions to the Hartlepool Mental Health Unit and the following year 2003/04 this reduced to 385 admissions. Typically, Easington residents make up around 33% of total admissions to the unit. In 2003/04, this equates to approximately 130 admissions.
During the period April 2002 to March 2003 there were 35 admissions to Hartlepool Older Persons Mental Health Unit and this figure was similar in the year 2003/04 when it was 34 admissions

A priority for investment in 2004/05/06 local delivery plans will be the further development of the community infrastructure of services required to support the combined care centre model proposed for the new facilities in Hartlepool.
The assumption is that two beds will be required by Easington residents under the new arrangements.

As part of the Advance proposals a specialist rehabilitation and recovery unit will be developed on the Parkside site in Middlesbrough and will service the populations of South Easington and Teesside where specialist in-patient provision is required. However, as with the rest of the services, through investment by local primary care trusts, there has been significant development in community infrastructure to support this client group and, in particular, the local assertive outreach team based in Easington will provide the majority of support to the majority of service users as close to their own homes as possible. South Easington residents will also continue to have access to both rehabilitation and continuing care facilities provided locally within Mulberry House in Easington.
There has only been one Easington resident admitted to the Hutton centre in the last 3 years. However, there are a number of County Durham residents currently being treated in the private sector or NHS out of the area.

L OCAL IMPROVEMENTS IN E ASINGTON TO AVOID THE
NEED FOR TRAVEL OUT OF COUNTY FOR SERVICES

Over the last 2-3 years there has been an increased investment in mental health in both primary and community services. For the period April 2002 to March 2003 Easington’s community staff reported a total of 110 service users on their caseloads. The following year 2003/04 reported an increase to 494 patients. This upward trend when compared to the reductions in inpatient admissions supports the evidence that a community focussed model which is at the heart of the advance proposals, will reduce the need for hospital admissions.

The proposed advance development of more specialist services on the St Luke’s hospital site will also allow patients to be treated much closer to their own homes than previously allowed. Example’s include eating disorder, mother and baby and forensic services where currently patients are being treated in Newcastle, York and further in order to meet such specialist needs.

C ONSULTATION WITH SPECIFIC INTEREST GROUPS.

In the spirit of the Section 11 guidance, the consultation and involvement around the Advance Project began over 2 years ago when the Trust began to discuss its plans with local stakeholders, including a number of user/carer forums including focus groups in each locality, LIT groups, the Trust’s own User/Carer reference group which all include representatives from the above.

As part of the formal 14 week Section 7 consultation process all the above groups have been sent the formal consultation document and have been offered the opportunity to discuss any of the issues further either directly within their own forums or as part of LIT discussions. In addition the Trust in partnership with Easington PCT held a locality-wide consultation event on January 14 ^th at Shotton Hall which attracted over 70 people from across the area to take part in a wider debate on the future of services for the Easington Locality and the future design of any new premises proposed.

E QUITY OF S ERVICES - C OMPARISON WITH S ERVICES
IN THE R EMAINDER OF C OUNTY D URHAM

Secondary Mental Health Services for the people of Easington are provided via 3 main NHS Trusts in the area who are all at various stages in terms of introducing changes in line with National Service Frameworks around Mental Health, Older People, Children and the White Paper Valuing People & Learning Disabilities Services.
Once completed the various organisational plans to improve services for all Easington residents will compare favourably with services in other parts of County Durham offering improved equity of services.

L OCAL TRANSPORT SURVEY AND AUDIT OF TRAFFIC
SPECIFICALLY FOR C OUNTY DURHAM RESIDENTS

For County Durham residents, transport to health facilities in Tees Valley is a very important issue. As part of the Tees Acute Services Review, County Durham and Tees Valley Strategic Health Authority commissioned a comprehensive transport survey. The results of this survey specifically include recommendations for the people of County Durham and have already and will continue to influence the transport arrangements for the new facilities.

The Trust has already undertaken a more local survey to establish the requirements of Easington Residents if the new facility as proposed is moved from its current location at the University Hospital of Hartlepool to a new purpose build facility in Lancaster Road in Hartlepool (approximately 0.8m from the existing service), close to the current Marina development. Following initial finding an independent traffic survey has been commissioned.

Finally, as the Trust currently runs a courier service between all of its 42 sites across South Easington, Teesside and North East Yorkshire it has commissioned an internal feasibility study to assess the demand to convert some of these routes to a minibus service to be accessed by users, carers and staff of the Trust.

What changes are needed to make sure that public transport and access is easier to the new facilities from County Durham

The key will be to ensure that the need to facilitate easy transport links particularly for those who use public transport is genuinely pursued and that the practicalities rather than the theory of public transport journeys is recognised.

The Trust is discussing possible changes with local bus companies to ensure good access to the new facilities e.g. re-routing certain bus routes to pass directly by the new development. A commitment to ensure that improvements are delivered is important.

Car parking arrangements and future parking charges strategy

Bearing in mind County Durham residents will need to travel some distance to the new proposed facilities, car parking and car parking charges are important issues. In a recent survey undertaken by the Trust around 83% of the service users & carers visit the units by car. It is important, therefore, that there should be firm commitments to provide adequate car parking as part of these new developments. The Trust has indicated that it supports this approach.

In terms of car parking charges strategy, the Trust currently runs a free car parking strategy at all of its sites and at this point has indicated that it has no intention to change this as part of the new developments. This is an assurance which needs to be preserved in the event of any private finance initiative to provide the new facilities.

V IEWS ABOUT THE P ROPOSALS AS T HEY A FFECT C OUNTY D URHAM RESIDENTS

Contact has been made with the local Patient Forums and the Durham County Service User and Carer Forum. Seeking views from those who will be affected is not easy. One written representation was received from a member of the Easington Forum who expressed concern about the future in relation to the ageing population and whether the proposal adequately anticipated this major change in demographics. There was also concern about younger patients and whether there were sufficient staff resources to ensure a timely intervention relating to the emergency care unit at Hartlepool. Similarly, there is concern about staffing shortages to support clients in the community.

Very often, the traditional consultation methods are not very appropriate where service users are experiencing mental health difficulties. The overall view as far as Durham is concerned appears to be positive in that more local services are being introduced to avoid travelling to units out of the County. For those patients who need specialist in-patient or out-patient care, new purpose-built facilities are seen as beneficial.

2005 Mar 22



Attachments

 Item 3a.doc;
 Item 3.doc