Agenda item

CNTW / TEWV Updates

Representatives from Cumbria, Northumberland and Tyne & Wear NHS Foundation Trust (CNTW) and Tees, Esk and Wear Valley NHS Foundation Trust (TEWV) will be in attendance to provide an update in respect of the following:-


  • CAMHS at Acklam Road Hospital / Lotus Ward Admissions 2021/2022
  • Respite and Short Break provision
  • TEWV Performance 2021/2022 – Q1
  • Community Mental Health Transformation Programme



Lotus Ward – Acklam Road Hospital


Representatives from Cumbria, Northumberland, Tyne & Wear NHS Foundation Trust (CNTW) gave a presentation in respect of the recently opened Lotus Ward at Acklam Road Hospital.


In terms of background it was advised that CAMHS services at West Lane Hospital had been closed in 2019 following CQC regulatory action. A formal request was then submitted by NHS England/NHS Improvement (NHSE/I) to establish a CAMHS inpatient service in Teesside and following Board approval CNTW had agreed to provide a 10 bedded General Adolescent Inpatient Unit for young people aged 13-18 years.  


‘Lotus’ had been selected as the name of the ward (a symbol of regeneration) following research and engagement with young people residing within Ferndene and Alnwood Wards and Lotus Ward was to be managed by the Trusts’ Specialist CAMHS Clinical Business Unit within the North Cumbria Locality Care Group. It was advised that Lotus had opened on 5 April 2021 following NHSE/I approval and CQC registration and patient occupancy had commenced on 10 May 2021.


With regard to admissions there had been 15 admissions to date 13 transfers, 2 direct admissions and information was provided in respect of the localities from which young people had been referred into the service, as follows:-


Localities: Co Durham (6), Tees (4), Sunderland (2), North Yorkshire (1), Gateshead (1), North Cumbria (1) and the average length of stay was 34 days.


As part of the ensuing discussions the following points/questions were raised:


· In response to a query as to how confident CNTW were that the measures taken this time would work and the issues experienced in the past would not be repeated. It was emphasised that CNTW was confident in the approach it had taken to establishing the unit and the whole team around getting the environment right and ensuring value based recruitment. In terms of staffing ratio it would be one of the better established wards, the clinical leadership and number of Band 6 staff appointed would ensure staff at the unit had considerable experience. This was further strengthened by the presence of Medical Directors.

· Reference was made to the need to at times use restraint to safeguard individuals, other patients and staff but there would be no use of mechanical restraint at Lotus.


AGREED that the information in the presentation be noted and a visit to Lotus Ward for members of the Committee be arranged in advance of the next meeting.  


Working collectively to review the mental health system - Update


Representatives from Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV) gave a presentation entitled working collectively to review the Mental Health System. The presentation highlighted the vision and outcomes envisaged for Community Mental Health Transformation, the action that had been taken over the last 6 months, how staff and service users had been involved, the PCN pilot and developments including the introduction of PCN Mental Health Practitioners, Patient Feedback and the Design Event. 


It was advised that the aim of NHS England’s Community Mental Health Transformation Programme was to develop an operational place based model for Adult Mental Health (AMH) and Mental Health Services for Older People (MHSOP) functional community services which were integrated with Primary Care Networks (PCNs) and Voluntary Care Sector (VCS) services and delivered services to meet the needs of those with severe mental illness. The model needed to be coproduced with staff, stakeholders, the local community, service users and carers.


It was envisaged that the new model would ensure:-


· People received a good-quality assessment at whatever point they presented

· Meaningful interventions for mental health problems were readily available and accessible

· Location was most appropriate to people’s needs

· Care could be stepped up where or when more specialist care was required, and stepped down, in a flexible manner without the need for cumbersome referrals and repeated assessments

· There were effective links with community assets to support and enable people to become more embedded within their community and to use those assets to support their mental health.


As part of the ensuing discussions the following points/questions were raised:


· Members expressed the view that it was quite overwhelming in terms of the scope and amount of work involved;

· In terms of feedback, often the percentages were low and it was queried as to the percentage of feedback received in respect of the PCN pilot. In response it was advised that every patient seen via the PCN Mental Health Practitioner was invited to provide feedback and the feedback percentage was approximately 6 per cent, which was quite significant. It was noted that 6 per cent in terms of the family/friends test carried out in the NHS was quite a high response rate. In effect that would equate to 1,440 responses from 24,000 appointments;

· A Member commented on the emphasis on patient need rather than service need, which was positive, however concerns were expressed that potentially there would be higher demand in certain areas and it was queried how this would be managed. It was acknowledged that the need for mental health support had increased significantly over the last few years and this investment was a real step forward in increasing the number of staff and services people could access from community mental health services. In addition there had been significant investment in the IAPT services in Tees so there was investment in increasing the number of assessments at the front end. However, understandably demand in specific areas remained an area of concern. It was emphasised that some of TWEV’s capacity was hampered by people being moved around the system whereas this was an opportunity for people to be seen once and to ensure that their care was co-ordinated. There was work currently undertaken that would no longer be undertaken once the system had been redesigned as a collective. Members expressed the view that this approach felt very encouraging.

· The work was such that no matter how much money was invested mental health services the work would increase, potentially a 40 per cent increase owing to COVID but if as a system we were able to get this right in terms of a system approach with Primary Care, VSC, TEWV and substance misuse services and agree on a system approach in which the patient came first and services would approach patients rather than the patient have to visit a whole host of services then we would have a service for the future.

· In response to a query it was emphasised that this was the start of a journey on what our interface of services would look like in the future. There was also the potential to look at locality working to strengthen the model as the ‘ask’ could be different in Middlesbrough, Stockton, Hartlepool, Darlington and Redcar & Cleveland.


AGREED that the information in the presentation be noted.

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