Agenda item

Representatives of NHS England, Lesley Patel (Director of Nursing) and Andrew Simpson (Transformation Manager Mental Health Learning Disabilities) to provide a presentation on the consultation for the proposed redesign of learning disability and autistic spectrum disorder services in the North West.  

Representatives of NHS England, Lesley Patel (Director of Nursing) and Andrew Simpson (Transformation Manager Mental Health Learning Disabilities) provided a presentation on the consultation for the proposed redesign of learning disability and autistic spectrum disorder services in the North West.  Also present at the meeting was Lee Taylor, Chief Operating Officer representing Mersey Care. 

The Overview and Scrutiny Officer reported that the reason for the extra-ordinary Committee was to provide Members with updated information on the consultation for the proposed redesign of the services in the North West affecting Mersey Care Whalley. 

Andrew Simpson provided a presentation on the proposal including the following issues:

·        An appreciation of the challenges posed for the large workforce.

·        Setting the scene for the consultation including the key documents and transformation of care.

·        Provided reasons for the case for change including money saved to be re-invested and that the outcome would be in the best interest of the community.

·        Details of the proposal to consider services for medium and low secure services.

He referred to the two options provided in the proposal:

Option 1 (Preferred Option) – low secure beds with longer term needs.  He reported that the design and location for this had not yet been decided and would possibly be located across the North West.  He pointed out that it was their aim to provide bespoke care for patients. 

Option 2 – to retain the site with less beds with this option being broken down further into 2A and 2B depending on the amount of beds retained at Whalley (Not the Preferred option).  

Members raised the following points:

·        Reports had shown mental health to be under-funded and under-resourced and consequently there was concern about if funding could be guaranteed to continue. 

·        The previous closure of part of Calderstones had seen service users move into the community at the expense of property procurement and service user relocation.  Properties were later sold and service users relocated once again.  Concern was therefore expressed that that this may be repeated and for the welfare of the service user and accessibility by their families.

·        Would the relocation of service users into the community be safe for local residents?

·        That Mersey Care Whalley complied with specifications provided by the Inspectorate and that it currently provided a good service and was implementing changes in culture which would meet the transforming care agenda.  The Committee believed that Mersey Care Whalley still had a part to play in providing a good service. 

·        Fewer people were training to become mental health nurses and Mersey Care Whalley already had qualified and experienced staff to provided good health care service.  Had consideration been given to how appropriately trained staff would be found to provide the care quoted in the consultation.  

·        It had taken years for the hospital to build a relationship with the community and information was provided on the type of initiatives implemented.  Concern was expressed about how to reproduce this level of support.

·        Concern was expressed about the picture of a child and wording in the document which did not accurately reflect the purpose of the hospital. Members considered that the consultation was misrepresentative and did not portray a balanced view.

·        The Maplewood buildings were new, opened only four years ago and 21^st century accommodation which had not been reflected in the consultation which had presented Mersey Care Whalley as an old hospital with old buildings in an isolated area.

·        Two relevant reports to changes in mental health services had not been addressed in the consultation:  Prison Reform Trust – 20-30% of offenders had learning disabilities and lacked appropriate support services and the 2009 Bradley Report – requirement for better mental health screening on arrival to prison.  Members pointed out that these issues should have been reflected in the consultation and the remodelling of the proposed service.  

·        The closure of the hospital would be costly at times of budget cuts.

·        The consultation had been released during a holiday period and local residents had not been consulted properly.  People had not been fully informed and there had not been any public meetings to discuss issues. 

·        Members felt that decisions had already been made and the consultation document was just paying lip service to a process.

·        Only 300 people had responded to the consultation and the site employed 800 staff.  Had service users been fully informed of the proposed changes and had they been fully informed of the consultation document, which was complex and difficult to understand.

·        Confirmation was requested of how many beds would remain under Option 1 of the proposal.

·        If Option 2B was chosen there would be a saving of £2.7 million – would this amount be re-invested in services at Mersey Care Whalley including for training and support.

·        It was pointed out that Mersey Care had taken over six months ago and cultural changes at the hospital had already begun to be implemented.

·        Reference was made to capital costs and that the consultation reported that capital costs had not yet been approved.  Questions were asked what would happen should approval not be given for capital funding. 

Responses to the above comments provided by representatives of NHS England were as follows:

·        Each patient would be eligible for a dowry which would follow them for their care. 

·        There had been an overall reduction in the number of beds being used at Mersey Care Whalley. 

·        A review for longer term care was required and the quality of life for patients was important within the review.

·        It was considered that cultural behaviour at Mersey Care Whalley required change in order to move away from an institutional approach. 

·        Community relations were important and a good model was in place in other areas which would be used in Whalley.

·        It was considered that the buildings constructed on the Whalley site met the former model standards but new buildings would be required to provide the transformation of care planned. 

·        The images printed on the consultation document were taken from NHS England pictures.

·        NHS England had liaised closely with organisations working with service users.

·        There had been a massive response to the consultation which would be analysed independently.

·        Under Option 1 there would be 70 beds made available. 

·        If Option 2B was chosen there would be a saving of £2.7m and a good case for a business plan to reinvest this funding in services at Mersey Care Whalley.  There would be support for this.

·        An independent company would analyse the responses to the consultation (approximately 300) and from this a decision would be taken which would be made available to all.  All responses would be included and a recommendation made to NHS England. 

·        A decision on capital funding had not yet been taken but the proposal for transforming care had been designed for capital to follow the decision.

Lee Taylor, Chief Operating Officer at Mersey Care, explained that hospitals had existed because people had not had access to the right support and that it was a big element for Mersey Care to support staff in providing the new model.  He suggested that any savings from changes should be built into the cost of the service. 

Resolved                            (1)  That the Committee recommends that Hyndburn Borough Council supports Option 2B as set out in the ‘Consultation for the Proposed Redesign of Learning Disability and Autistic Spectrum Disorder Services in the North West’;

                                            (2)  That the Committee’s disappointment be noted in the consultation process and the lack of reflection of the true service provided by Mersey Care Whalley in the consultation;

                                            (3)  That it be noted that there was still a requirement for low secure care at Mersey Care Whalley; and

                                            (4)  That the Chair of the Committee, with the Support from the Overview and Scrutiny Officer, provides a full response to the consultation which expresses the views and concerns of the Committee.