Issue - meetings

Adult Mental Health Inpatient and Rehabilitation Services Redesign

 

 

Meeting: 19/05/2025 - Health, Care and Wellbeing Scrutiny Committee (Item 59)

59 Adult Mental Health Inpatient and Rehabilitation Services Redesign pdf icon PDF 520 KB

To provide an update on Herefordshire and Worcestershire Health and Care NHS Trust’s Adult Mental Health Inpatient and Rehabilitation Services Redesign.

 

Additional documents:

Minutes:

The Chairperson invited representatives from the Herefordshire and Worcestershire Health and Care NHS Trust (the trust) to update the committee on Adult Mental Health Inpatient and Rehabilitation Services Redesign.

 

The principal points of the discussion are summarised below:

 

  1. The Chief Operating Officer referred to two related schemes as referenced in the report: 1. Quality improvement scheme that is focused on the improvement of patient pathways on acute mental health wards with the outcome of eliminating inappropriate out-of-area placements. It was noted that this scheme is coming to an end and does not have an immediate bearing on services provided in Herefordshire. 2. Longer-term piece of redesign work for mental health rehabilitation.

 

  1. It was added that Mental health services are provided to around 20,000 people across the two counties of Herefordshire and Worcestershire each year. Every year around 450 people are admitted to a specialist in-patient bed and of those only 30-40 require a rehabilitation bed.

 

  1. There are currently about 50 acute beds with one ward at Stonebow and two at Elgar supplemented by a 9-patient intensive care unit.

 

  1. The complete refurbishment of Stonebow has recently been finished so all three wards have now been completely rebuilt to modern standards.

 

  1. It was noted that admission to acute care is something that is considered when community care cannot be safely provided and a patient would likely be in there for 25-30 days. For rehabilitation units, this is for patients with persistent challenging conditions or are highly disabled by their mental health condition and admission is for a year or longer. In Herefordshire, there are ten beds at Oak House.

 

  1. Following a review of rehabilitation provision across the two counties, the adoption of the Getting It Right First Time (GIRFT) methodology which is supported by the Royal College of Psychiatrists and the NHS England commissioning guidance has been used to look at rehabilitation mental health services to compare those to national standards for mental health rehabilitation. In the review, it has been realised that local rehabilitation services are not the best fit for the needs of the current population.

 

  1. All the units across the two counties are often not of the right design or to the right specification to provide care for the more challenging patients that require rehabilitation in both counties. The implication for that is that patients are placed out of area and currently there are 9 placed out of area. Additionally, out of the 50 acute inpatient beds, there are 17 who have been in acute hospital for more than 60 days and many of those would benefit from rehabilitation, however, there is not the right profile of beds across the two counties.

 

  1. Another factor considered in the redesign is Oak House which is a ten-bed unit based in a Georgian house. There is a lease on it which ends in 2027. The building has considerable limitations including line of sight, accessibility problems, and it cannot be fully de-risked.

 

  1. The redesign programme started in January 2023 and has followed the  ...  view the full minutes text for item 59