To provide an update on Herefordshire and Worcestershire Health and Care NHS Trust’s adult mental health rehabilitation services redesign.

The committee considered a report on the Adult Mental Health Rehabilitation Redesign – Update item.

The principal points of the subsequent discussion are summarised below:

1. The Herefordshire and Worcestershire Health and Care NHS Trust provided an update on its adult mental health rehabilitation service redesign programme. It was noted that the programme had been developed over a two-year period and sought to ensure that people received the right care, in the right place and at the right time.

2. The committee heard that the trust currently operated three inpatient mental health rehabilitation units across Herefordshire and Worcestershire, providing 33 beds in total. Rehabilitation services are intended to support people to develop the skills required to live as independently as possible, with level one rehabilitation focused on daily living and functional skills and level two rehabilitation providing more intensive clinical stabilisation.

3. It was reported that the preferred option is to establish a community rehabilitation team for level one rehabilitation, reduce the number of rehabilitation beds from 33 to 18, and procure level two rehabilitation beds from external providers. The trust considered that this would enable it to support a greater number of people in their own homes and communities, with the proposed community service expected to support up to 135 people.

4. The committee was advised that the option appraisal had involved clinical modelling, expert panels and engagement with staff, local authority and integrated care system colleagues, the voluntary and community sector, public health, and people with lived experience. It was noted that the process had been paused during 2025 to consider new potential providers of bedded facilities, although this had not changed the preferred option.

5. In response to questions about the planned closure of Oak House, the trust clarified that Oak House is a rehabilitation unit rather than a secure unit. It was confirmed that the proposals would not affect the secure mental health bed provision at Stonebow. The trust stated that the resources currently used for Oak House would instead support a community rehabilitation offer, although bedded rehabilitation capacity would remain available in Bromsgrove where required.

6. The committee noted the trust’s view that public-health modelling indicated that the proposed model should reduce the need for out-of-area rehabilitation placements. However, concerns were raised regarding access for Herefordshire residents required to attend a Worcestershire-based unit, particularly for people without access to a car and for their families and support networks. The trust acknowledged that detailed transport arrangements had not yet been developed and would require further work.

7. Members also raised concerns about the practical delivery and affordability of community provision in a rural county, including the availability of housing to support discharge and recovery. The trust advised that the proposal is intended to be cost-neutral, with staff from units proposed for closure offered opportunities within the community rehabilitation team. It was added that the trust had experience of a similar model through its hospital-at-home service.

8. The trust explained that a detailed implementation and transition plan would be developed only if the proposal passes  ...  view the full minutes text for item 27