Minutes:
10.1 The Chair stated that the Commission had been asked by Cllr Selman and by Healthwatch Hackney to investigate a worrying rise in the waiting times being experienced by mental health patients in Homerton A&E in being admitted to a mental health bed after they had been diagnosed as requiring one and that long waits at A&E were particularly inappropriate for this cohort. The Chair had asked Nina Griffith (NG), Director of Delivery, City & Hackney Place Based System to provide a verbal report.
10.2 NG gave a verbal report. It was common for people in mental health crises to be taken to an ED because these are deemed to be safe places where people can seek an assessment and access other services they need. Police can bring them there also. A key performance measure here is the time people wait between a decision to be admitted being made and actual admission and the target points are 4 hrs and 12 hrs and nobody should wait 12 hrs. In the past very few had breached this standard. In the past 8 months however there were a number of breaches and this problem as a pan London one pointing to the increased demand on mental health crisis services and on mental health beds. It was not an acceptable situation as all partners were focused on this at C&H, NEL and London wide levels. Locally there has been an increase in demand both on mental health beds but also seeing an increase in length of stay in in-patient wards so both creating the pinch point and blockage. As regards solutions, they have put in place extra capacity creating a Section 136 suite as well as additional capacity away from A&E in the Reybould Centre which ELFT operates on another part of the Homerton site. That creates a calmer environment for those in crisis. Capital works are also ongoing to create extra capacity for those needing mental health beds and this will open in January.
Secondly ELFT is procuring an additional 40 independent sector inpatient mental health beds to also help ease the pressure. The plan will be that those extra beds will be for Out of Area patients and will release the main ELFT beds for local area patients. She added that in an ideal world you would never put people in Out of Area beds as they require the wraparound care from community services from their own local area. They are trying to ensure the most optimal pathways to keep local patients within in-area beds and this should free up significant capacity within the system to enable that.
The third area they are addressing is length of stay and the flow. Additional discharge monies have been announced through ASC Discharge Fund and part of that locally will go on mental health discharge. In addition and separate to that they’ve commissioned additional step down capacity in b&bs for those who can’t be easily discharged into their own homes so there is a significant programme of work led through ELFT to really support flow through wards. She added that this subject was receiving significant attention at the highest levels and had been discussed the previous week at the Neighbourhoods Health and Care Board and there will be a City and Hackney Health and Care Board Development Session on it on the coming Thursday.
10.3 The Chair asked what was the source of the additional funding as 40 new independent sector beds was quite a commitment and was it covered by reserves and how long is the funding commitment for. NG replied that the funding is from the Mental Health winter monies and is not being taken out of anyone else's funding pot and it will run until the end of March when the situation will be reviewed.
10.4 A Member asked when we are likely to see the pressure here being relieved. NG replied from January when the new capacity is in place.
10.5 The Chair thanked NG for her prompt and detailed response and suggested that possibly in Feb or March there could be a more formal item looking at what progress has been made.
ACTION:
Update on emergency Mental Health in-patient capacity to be added to future work programme.
RESOLVED:
That the update be noted.