To receive an update presentation in respect of provision of acute mental health services.
Minutes:
Consideration was given to a presentation on Adult Acute Mental Health Services delivered by Rotherham, Doncaster and South Humber NHS Foundation Trust. The presentation included a description of services and touched on performance, achievements, and challenges of service delivery in Rotherham.
In discussion, Members sought additional information around action plans that respond to the recent CQC review and the identified areas needing improvement. The response from Partners explained the action plan is 75% achieved, with emphasis on recognising what constitutes “good” in various categories and scenarios of daily service delivery. Partners noted that if a problem is found steps are taken to address the problem, with the action left open until fully resolved everywhere in the organisation. The response gave further details of the RAGB rating system by which performance objectives are reviewed. Where there was additional complexity in improving a specific performance objective, such as timely commissioning, and where performance objectives are linked, details were provided as to the prioritisation of actions against those that are categorised by the CQC as “Must Do” and “Should Do.” It was noted that in some areas of the organisation, the service specifications are 3-5 years old and are due to be reviewed and revised. During COVID the action plan had been suspended, as the paramount objective was safety.
Members requested further clarification of the term “immediate assessment” and of the timelines from assessment to treatment. The response from Partners supplied more details around the assessment process and Crisis pathway, included the Blue Light Service. A distinction was made between emergency/urgent standards in community versus hospital care settings. Staffing and workforce was noted as the main determinant of rates. Members proposed that a breakdown of response times and internal waits be supplied as part of thorough performance data in the next report.
Members requested detailed data in a more comprehensive report, with focus on Rotherham. Partners offered to bring this report to a future meeting along with supplementary narrative around the crisis service to help provide a full picture of service delivery.
Members expressed interest in more information around how COVID has affected intakes. The response from Partners noted that while there has been an uptick in new patients during COVID and lockdowns, there are also many who have not been seen for years but are now requiring care, and still others who have been stable recently but who have deteriorated during the recent strains. Currently a broad piece of work is being undertaken to better understand the reasons for this uptick in admissions, and whether other upstream interventions could have helped avoid sojme of these. Whether it be employment loss, grief, family or relationship breakdown, further analysis is being undertaken.
Members expressed concerns regarding out-of-area beds limiting patient access to loved ones. The response from Partners noted that patients had been moved as far away as Bristol and other similarly significant distances in order to find the specialist care necessary for the patient’s needs. These distances place pressure on the family and often prevent the patient from receiving visits from loved ones. It was observed that anywhere away from home is too far for patients; therefore, a block of beds had been purchased to help mitigate the pressure.
Members also requested further information regarding staff wellbeing. The response from Partners noted various efforts to enable agile working and culture that promotes staff wellbeing. It was observed that most staff absences since the pandemic began were stress-related.
Resolved:-
1. That the update be noted.
2. That the next update be presented in six months’ time, to include information about response times and staff wellbeing as well as narrative around crisis service.
3. That the outcome of the Community Mental Health Transformation also be presented when available.