Mental health '˜centre of excellence' plan for Worthing
Mental health services and beds currently based in Chichester could be closed and be transferred to Worthing and Crawley.
As part of a major review of NHS mental health services across Sussex, new ‘centres of excellence’ could be built at Swandean Hospital in Worthing and Langley Green in Crawley.
The whole strategy would see overall beds across Sussex reduce and a public consultation take place.
The Sussex Partnership NHS Foundation Trust’s (SPT) announcement, as part of an update on its new clinical strategy, received largely critical response by West Sussex County Council health watchdogs today, Thursday, March 8.
Council members of the health and adult social care committee (hasc) labelled it a ‘hard sell’ to patients and families who may have to travel further.
Councillor James Walsh, hasc vice chairman, asked how, with mental health beds across West Sussex full at 105 per cent capacity, it could consider closing beds and asking for extra funding.
Simone Button, SPT chief operating officer, explained that the move was part of the trust’s aim to move to 24-hour crisis services, to improve the outcome for patients and relieve the burden on hospitals and the police.
She told the meeting: “By 2019 we will start putting the strategy into action.
“This would mean changing some accommodation in the Chichester area.
“Something the Care Quality Commission picked up on at their last two inspections is the deficiencies we have in couple and single gender beds as well as the fabric of buildings like the Howard Kidd Unit (Chichester) which we cannot do anymore to.
“We have been thinking about solutions and one is to create two new centres of excellence across West Sussex.
“So we would move services from Chichester to Worthing (Swandean), all wards for dementia and older service users would be relocated there.
“Langley Green Hospital would get the beds for working age (patients), and move alongside the psychological intensive care unit there.
She added: “This is an early proposal but we think this would be a good way for us to deliver high quality care.”
She said along with the new dementia ward at Brighton it meant the trust ‘could afford to lose some beds’.
Councillor Walsh said: “Firstly I would like to congratulate the trust on its ‘good’ CQC rating.
“But I feel there’s a fundamental disconnect with you targeting 85 per cent bed occupancy, not using out of area or private beds but then saying you are going to close more beds.
“Two or three years ago you closed beds without telling anybody.
“And now you are at 105 per cent occupancy and you want to reduce beds, that can’t possibly marry up.”
Mrs Button responded: “We are working on patient flow so more people stay out of hospital...so we would need fewer beds.”
Councillor Frances Russell, chairman of Healthwatch West Sussex, said: “The impact these centre of excellences would have on travel is much bigger than you possibly realise.
“Those living in rural areas like Midhurst already have no way of getting to Chichester.
“What you are talking about is very building-based and that worries me because that does not work for people living in this area.”
The meeting heard that demand for mental health services across East and West Sussex, which has one of the oldest populations, was growing.
Coupled with ‘unprecedented pressures’, carrying on as it does now means the trust’s inpatient and community services ‘will not be clinically or financially sustainable’, the SPT said.
That has led to Sussex and East Surrey Sustainability and Transformation Partnership commissioning the strategic review of mental health services last year, to lead to better cohesion between NHS organisations and the voluntary sector.
Part of the Partnership Trust’s strategy will be to ask for more funding.
Mrs Button said: “There are some really important figures that have shaped this.
“People who use mental health services live 20 to 25 per cent less than the rest of the population.
“Seven per cent of the population have mental health problems, but 20 per cent of A&E usage is from people with mental health issues.
“So it’s really important we get increased investment from our crisis services.
“We have been working hard to try to relive the crisis on A&E but with our service currently running from 8am to 5pm (Monday to Friday) that is difficult, which is why we need to move to 24-hour crisis care.”
Councillor Kate O’Kelly questioned how easy getting extra funding would be, and asked about the shortage of staff.
Mrs Button said: “We do have workforce challenges like other organisations but we’ve made good progress in terms of nurses with a robust recruitment strategy which has seen retention rates improve.
“The issues of psychiatrists continues to be challenging in relation to West Sussex. We have really struggled to recruit across the county.”
Brian Salt from the Partnership Trust said it had recruited new physician associates ‘to relieve the burden’ on consultants and, under supervision, give assessments and manage drugs.
Councillor O’Kelly however said: “These proposals will require high calibre roles within your workforce, not low calibre and possibly quite expensive.”
Regarding the potential moving of services, she added: “It’s going to be a hard sell and incredibly challenging to take everybody with you on this.”
The meeting also heard that huge demand over the winter had seen 26 patients placed at units outside of Sussex, though just one remained out of county now.
The six patients placed at privately-owned The Dene in Hassocks had all been moved following a damning Dispatches TV investigation, which aired in February, the trust said.
Mrs Button said a public consultation on the new centres of excellence was likely to take place at the end of this year.
Councillor Walsh commented that ‘even the most optimistic person cannot possibly think it would be in place by 2020’.
A Sussex Partnership Trust spokesman said after the meeting that the Oaklands unit in Chichester could be maintained for ‘extra provision’ if the changes take place.