Verbal update
Minutes:
Central and North West London NHS Foundation Trust (CNWL)
Ms Natalie Fox, Service Director for Older Peoples Services, CNWL, updated Members on the recent consultation on proposed modernisation of Hillingdon Older People Mental Health Services in Hillingdon. Ms Fox wished to have Members approval to move forward with the next steps of the consultation; staff consultation.
In May 2011 CNWL set out proposals to change the mental health services for older people in Hillingdon and in July 2012 the External Services Scrutiny Committee were informed that modernisation of the services was under consideration.
Ms Fox explained to Members that the 12 week consultation period started on 13 August 2012. During this time period 2 public meetings were held on 25 September and 24 October. The consultation ended on 4 November and an external organisation (Verve Communications) were commissioned to undertake an independent evaluation of the consultation.
Ms Fox explained that during the consultation that 300 consultation documents were circulated to a range of stakeholder as well as 200 flyers were printed; which highlighted the consultation period and promoted the public meetings. The consultation information was also detailed on the Trust’s website and was available to download online. There were two advertisements placed in the Uxbridge Gazette which highlighted the dates of the public meetings.
The two public meetings were held in September and October where OPHA staff delivered a presentation on the proposed changes and answered queries and addressed concerns from the public. Announcements regarding the consultation were made at both internal and external meetings within the CNWL, Hillingdon PCT, OPHA management meetings, Trust-level meetings, contract meetings with commissioners, Partnership Board meetings and Overview and Scrutiny meetings.
Ms Fox stated that a total of 37 attendees for the meetings held in September and October 2012. These included councillors, carers, staff and representatives of different organisations. 6 responses were received during the consultation. All comments and queries were recorded in the meetings and relayed to Verve Communications to include in their evaluation.
The types of issues raised were broken down into five broad categories which included; community care, reduction of beds/ward closures, treatment, financial resources and respite. Although some questions did not relate directly to the consultation issues they were still answered by senior staff from the CNWL OPHA in attendance.
Concerns were made regarding the effect the proposals would have on community services and if they would have the ability to respond to increased demand. It was also questioned whether the savings would be reinvested in community care, care homes and improved hospital care and if so these details should be communicated to those involved in care.
Concerns were made about whether there would be enough beds for patients who needed hospital care and whether this would increase waiting times for hospital care. Suggestions were made to use beds earmarked for closure for respite care.
A range of questions about the effects on various treatments that patients would receive if the proposals were approved included concerns regarding drug administering, age related issues on wards, mixed treatment wards, fast tracking dementia patients through A&E, the Rapid Response Team dealing with drug/alcohol problems and the Memory Clinic.
In relation to financial resources questions were asked about the current cost of the service and who would decide on how things were spent. There was a suggestion made that some of the proposed bed closures be used for better respite care.
Observations were made by a representative from Verve Communications at one of the public meetings they attended. Most of the issues were responded to by OPHA staff/clinicians in attendance, however written follow-up responses were needed for a small number of questions. Attendees seemed satisfied with the meeting and the way it was conducted. CNWL OPHA staff responded to issues in an informative and professional manner. Attendees were seeking assurance that enough beds would remain and that savings would be reinvested in ward staff and community services.
The Uxbridge Gazette highlighted the issues being consulted in a press article on 31 August which was also posted online. There was also a post in the West Drayton & Yiewsley community section of the newspaper’s website on 4 November. No readers’ posts relating to the proposals were submitted.
Ms Fox explained that the next step of the consultation was to present to the Trust’s Council of Members to agree proposals to a consultation with staff regarding redeployment.
In summary, from the material received, from observations at one of the public meetings, and from the absence of any negative campaigning or adverse press coverage, Verve Communications noted that there appeared to be little opposition to the proposals.
Ms Fox explained to Members that there was under occupancy on bed usage in Hillingdon in this area and the organisation wished to increase the ratio of staff to beds. That if additional beds were required the service would be able to access a bed across the 5 Borough’s that were covered.
Miss Fox explained that there would be a shift of resources as a gap in the services had been recognised. The proposed bed closures to run the ‘Memory Clinic’ and up-skill staff was discussed in further detail. Miss Fox explained further that the consultation clearly outlined how money would be spent. During the consultation concern was made regarding the need for better respite care.
It was discussed that the 40 beds in Hillingdon, for dementia and for functional issues such as depression was the highest number of beds across all CNWL older people services. A Member advised the Committee that he attended one of the events and verified it was well natured. There were concerns made about dementia in respect of the long waits for initial appointments and longer waits for follow-up appointments. He also stated people were keen that the Memory Clinic had an investment. The general feedback was this proposed change was something people could tolerate as they could see the bigger picture.
Dr Pramod Prabhakaran, Consultant Psychiatrist, CNWL, explained that he felt people with depression should not be treated the same as people with dementia. He explained that dementia is an organic change in the brain and highlighted there that there should be separation in the ward with focus on individual groups and 1 to 1 care given to those with dementia.
Members thanked Ms Fox and Dr Prabhakaran for attending and updating the Committee on the consultation. Members were happy with the feedback received to date and agreed that the consultation should move forward to the next stage.
RESOLVED: That the presentation be noted.