This is to discuss the current consultation regarding the George Bryan Centre. A link to the consultation and associated documents can be found here Consultation Documents and Survey - Staffordshire and Stoke-on-Trent, Integrated Care Board (icb.nhs.uk)
Minutes:
The Chair welcomed
representatives from the Staffordshire
and Stoke-on-Trent
Integrated Care Board - Chris Bird, Chief Transformation
Officer (including executive leadership for delegated
responsibilities the ICB have for general practice services),
Nicola Bromage, Associate Director – Mental Health, Learning
Disability and Autism and Children and Young People and Dr Abid
Khan, Medical Director of Midlands Partnership Trust.
Mr Bird informed members that the ICB was considered the statutory body for the consultation process regarding the George Bryan Centre. A link to the consultation and associated documents had previously been circulated to members and the Chair encouraged members to participate in the consultation process which was currently taking place around the future provision.
Nicola Bromage from the In-patient Mental Health Team, ICB delivered a presentation explaining the reason for the review, the present community support and the proposal for the mental health transformation. She said there had been a national model which the long-term plan had focussed on which needed to work differently in the community setting rather than hospital stays. She said they recognised they needed to enhance the community and mental health services by providing more mental health practitioners in GP settings, improving the continuity of care and focus on more personalised care with more integrated working so care is coordinated between teams. She advised that a lot of work was being carried out with partner organisations and with crisis teams with a crisis café in Tamworth recently opening. It was also very important to support the physical health needs as well as the mental health needs.
Community Mental Health case studies were shared showing the new pathways for mental health older adults and adults with dementia.
Ms Bromage advised that Older Adults Specialists had been appointed since the George Bryan Centre closed and said support was now available before diagnosis. She said the staff work really close within the community with voluntary groups, social services, council and other partner organisations.
The Proposal for delivering mental health services was clarified:-
Ms Bromage said since the fire in 2019 at The George Bryan Centre, Tamworth the Commissioners had been looking for a long-term solution for providing the services previously provided there and two suggestions had been proposed:-
1. Keep 18 beds at St Georges site in Stafford; and
2. Provide 18 beds at The George Bryan Centre.
However, after extensive research it was felt that only the one proposal was viable at the St Georges site in Stafford because it was felt a single isolated site would not be clinically safe in Tamworth. Ms Bromage said St Georges was significant and recognised as being able to provide better care with a psychiatric unit being able to provide rapid support with trained professionals on hand. The treatments were more varied i.e. art therapy/speech therapy and as the national best practice was to look at community-based projects this was recognised by the ICB as the best proposal even though the travel to Stafford was recognised as a disadvantage. It was possible with the community-based project that there would be fewer admitted into hospital in the future.
Ms Bromage said they were looking at the possible mitigations and encouraged members to comment using the consultation surveys especially with ideas for travel issues in how we can support people more effectively should the single proposal go ahead. She said they were looking at all previous suggestions i.e. offering financial support for travel costs/flexible visiting hours to enable people to visit at any time rather than constrained visiting hours making it impossible to visit via public transport.
Members made the following comments/observations and asked the following questions:-
· Members agreed that transport was the major concern with no rebuild at The George Bryan Centre in Tamworth as people in this district will find it very hard to commute to St. Georges in Stafford. A lot of elderly people in particular would find it difficult and members suggested the Support Staffordshire Voluntary Driving Scheme as an option. Concerns about travel to Stafford generally ensued as a lot of people do not have a car and the bus stops are not very near to their home nor are there enough bus services. It was concerning because if people cannot get there then this causes additional problems and visits from family and friends is very important. Definitely need a patient transport service.
Ms Bromage noted this and said if the proposal goes ahead there will be a ‘standard operating procedure’ looking at providing support for travel assistance.
· Members asked that the dementia patients be monitored and the data be reported back to a future meeting. It was noted that Lichfield and Burntwood were both dementia friendly communities and any help would be welcomed to improve peoples’ knowledge.
· Members asked if there was sufficient capacity at St. Georges in Stafford if the George Bryan Centre were not to reopen?
Dr Khan confirmed that there was enough capacity in his opinion as having a constant presence of a consultant on a ward was leading to a quicker turnover and therefore helping with capacity issues.
· Mental Health in younger people was discussed as this was very concerning now as it was agreed that bad mental health was being diagnosed younger and younger. Again, it was asked if the statistics for this could be monitored as experience had found that CAMHS were not very effective, and families and schools had to wait a long time and could not get the support when they wanted it. The suicidal thoughts. attempts and deaths of children were increasing, and members asked that this be looked at as a priority.
Dr Khan advised that the CAMHS services had recently improved in Staffordshire and assessments were being done much more quickly especially if the child has an acute need. The higher the need the more urgently they will be seen and so this should be stated on the referral. Dr Khan said that during the pandemic the NHS provided more training and expanded the CAMHS teams all across the district – expanding the specialist services in the community being paramount and making them more accessible to all.
· Members asked if there was enough staff?
Dr Khan said there had been a lot of success in CAMHS in the Midlands and the NHS were trying to home produce a lot of social worker staff and train and recruit overseas to community teams. He said a lot of planning for the workforce to become fit for purpose was being done.
Ms Bromage said the Community teams will respond to people in crisis and provide home treatment rather than hospital admission primarily but if a hospital admission is required then it would be facilitated. She said there were now two crisis teams working to keep patients closer to home rather than hospital.
· Members noted that in the recent budget, the government said they would put £10m into suicide prevention and support, is there any news on the allocation yet – is this something which could be supported?
Ms Bromage confirmed they had areas they would like to provide support and implement. No allocation yet known.
· Members asked if Mental Health professionals go out to the Police?
Ms Bromage said yes it was called street triage where a mental health nurse visits the police.
· Members asked if there was any extra support for carers looking after dementia patients at home?
Ms Bromage said that the requirement when The George Bryan Centre closed was recognised and an older age specialist team working with social care to maintain people in their homes and work together had been implemented and they had lots of work to improve this offer.
· Members asked if the Peer Support Workers were paid roles?
Ms Bromage confirmed that the roles were paid with career progression and there were some volunteers as well.
· Members asked if there was liaison with the probation service and a possibility for cross-over working?
· What can be done for men in mental health?
Dr Khan said that nationally, there is a lot more awareness of this subject now and it is changing slowly. The visiting people in their own homes in the community gives more opportunities for this to be recognised and help to be sought.
RESOLVED: The comments and observations be noted and the Chair requested that the findings of the consultation be shared with this committee in due course.