Issue - meetings

Amanda Kemp, Deputy Director of Local Services at Nottinghamshire Healthcare Trust (NHT) provided an update on progression of proposed service redesign projects within the Adult Mental Health Directorate in 2015/16.  The following points were highlighted:

(a)  feedback from a diverse range of stakeholders has shown that services are quite difficult to navigate, with too many internal barriers. 

Further feedback has suggested that it is quite difficult for GP’s to call up and speak to senior nursing colleagues.  This can mean that patients have to have repeated assessments;

(b)  NHT are looking to set up a much more locality based focus on services, bringing together skills of specialist teams.  This will aid seeing patients more quickly.  With a much stronger multidisciplinary team approach, staff from different medical teams can work together more closely;

(c)  in Nottingham City there are approximately ten teams operating.  NHT have proposed a single point of access for the three localities;

(d)  following formal consultation, there was strong support for the development of a Community Rehabilitation team in the Mansfield area;

(e)  questions were raised around whether enough money was being reinvested.  Programmes such as outreach at Broomhill House were really valued and important to service users and families.  Data on this topic will continue to be reviewed;

(f)  service users from homes that have previously shut down, such as Enright Close in Newark, have been tracked and some have had very positive outcomes, including being discharged from the service;

(g)  eCRHT (Enhanced Crisis Resolution and Home Treatment Team) has reduced the need for admission to hospital by supporting people in crisis;

(h)  the Mental health 111 service commenced in February 2015 and is funded by NHS England for one year as a pilot study.  Of the services users who contacted 111, 90% were diverted from the Emergency Department;

(i)  the eight week period from the start of September 2015 up until the start of November 2015 was exceptionally challenging for staff.  This was part of a national trend.  NHT was able to secure private beds in Nottingham for people requiring acute admission. Some out of county beds were also used.

  The picture has stabilised over the past six weeks, with only four out of area beds being used from week beginning 23 November.  Previously, this figure was higher;

(j)  NHT will review their bed capacity, and examine whether step-down beds are needed.  A high number of delayed transfers of care had a big impact on the number of beds used;

(k)  a review of patients with personality disorder is underway to see if community provision could reduce admissions to hospital.  There is NICE (National Institute for Health and Care Excellence) guidance that can help with managing this.

After questions from Councillors, the following information was provided:

(l)  historically, services have been delivered from a centralised point; this can lead to services in the north of the County looking different to service provided in Nottingham City.  The City does provide services that can  ...  view the full minutes text for item 44