Presentation by Justin Wilson, Medical Director, and Kate Sigov, Deputy Director of Children’s and Young People’s Services on various issues affecting mental health services in the local area.
Minutes:
Mr. Justin Wilson, Medical Director, and Ms. Kate Sigov, Deputy Director of Children’s and Young People’s Services at Surrey and Borders Partnership NHS Foundation Trust updated the Panel on various issues affecting mental health services in the local area.
Mr. Wilson began by speaking about the Trust’s clinical strategy. The Strategy underpinned all its work and had evolved to focus on prevention. This was particularly important when looking at the Children’s’ and Adolencent’s Mental Health Service model (CAMHS). The Trust was accountable for services but worked in partnership to get the best care for young people.
Mr. Wilson considered that there had been a real improvement in mental health services. The Trust’s values focussed on improving people’s lives – involving them in services and being open, honest and accountable about and for the services it provided. In terms of creating respectful treatment environments, the Trust’s main focus was around Surrey with the exception of its drug and alcohol services which were based in Croydon.
The Panel was aware that the Trust’s Wards in the Langley Wing at Epsom Hospital had been relocated. This was currently being stated as a temporary measure. Following a review of the wards, the Trust had concluded that, whilst the accessibility of the facilities for the locality needed to be balanced against the fact that care would now be provided further away from home for some, the environment there no longer enabled it to provide the type of surroundings the Trust wanted people to experience when being helped in their recovery. The surroundings at the Langley Wing were not in line with the Trust’s vision and values of creating respectful places and treating people well. The Delius and Elgar wards had therefore been consolidated with the Trust’s hospital services at the Abraham Cowley Unit on the St Peter’s Hospital site in Chertsey in early February 2017.
The Panel noted that the average length of stay as an inpatient was about 35 days and the focus of care was on enabling them to return home as soon as possible. The Trust rarely saw stays of a year. Readmission rates were good. The Trust did have services for older people with some units at West Park and a ward in the Abraham Cowley unit in Chertsey which focused on mental health (not necessarily dementia). The Trust aimed to get to the point when patients very rarely required to be admitted to hospital, particularly in dementia cases, but rather were receiving intensive support to enable them to remain at home.
The Trust had opened a new hospital at Farnham Road in Guildford just over a year ago. The emphasis on the new build was around environment: a state-of-the-art hospital with therapeutic surroundings that aided recovery and the Trust had a desire to replicate this in the East of the County. The Trust had originally intended to build three new hospitals but was now considering whether two hospitals would meet local needs. The Trust was liaising with commissioners on this with a view to future statutory public consultation. In the meantime, the plan was to continue with the interim relocation of services in Chertsey – certainly for the next couple of years. In order to fund the building of the second hospital, the Trust would need to liquidate some of its assets. However, this might not meet the full cost of a new build and so a decision might need to be made as to whether to borrow to build a new hospital or to improve existing services. In the latter circumstances, West Park might be an option for the location of services although it was less likely that those would be inpatient services.
Ms. Kate Sigov then went on to inform the Panel about the work the Trust was doing in Surrey with children and adolescents. The CAMHS model of care in Surrey was something quite different from what was being done elsewhere in the country. The social care partnership model, the Mindsight Project, focused on four areas of service: crisis support, specialist services, targeted services and wellbeing and resilience services reporting to a partnership board.
All referrals came into a single point of contact to be pointed in the right direction. Since April 2016, the service had taken over 26,000 calls resulting in 6,000 referrals and 91% of state schools were engaged with TAMHS (Targeted Mental Health Services in Schools). It was proving a challenge, with the current referral rate being over 28% over the expected rate but the service had received the endorsement of the Secretary of State for Health, the Rt. Hon. Jeremy Hunt, MP and 92% of clients said that they were extremely likely/likely to recommend the Trust’s services to friends and family.
Looking forward across the Trust in general, there was a pilot running in the Borough of Elmbridge regarding a single point of access for crisis services and considerable importance was being placed on enhancing liaison psychiatry. It was hoped to expand the portfolio of, and access to, the Recovery College which aimed to equip patients with skills for leading a better life. Community hubs and integrated care teams aimed to provide better care and value for money. The Trust was also working with Surrey University on a trial around technology integrated healthcare management, looking at how early intervention via technology could help those diagnosed with dementia remain in their own homes rather than be taken into care. The Trust had also recently successfully bid to take on children’s community services in partnership.
In response to a query regarding whether there was a crisis in young people’s mental health care, the Panel was informed about some of the measures being undertaken by the Trust. The Trust had a home service for the under 18’s and was launching its first safe haven – a café in Guildford – to meet with young people in crisis. Nurses where employed to deliver out of hours service and two respite beds were available for up to 10 nights in Guildford. The Trust was also working with a number of partners to try and understand the link between mortality and mental health to introduce early and accessible interventions with the aim of suicide prevention.
The Chairman thanked Mr. Wilson and Ms. Sigov for their presentation, noting that matters were still fluid and that members were hopeful that the location of a new build would be in the Epsom area.