NHS issue update on Mental Health redesign

Susan Carngie Centre at Stracathro Hospital

Susan Carngie Centre at Stracathro Hospital

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NHS Tayside has issued a programme update on their Mental Health Service Redesign Transformation Programme, including a list of four options identified at an engagement event in June

In the update, the health board set out their reasons for wanting to redesign the service, citing the current set up as “not sustainable”.

Work force challenges are also noted, with NHS Tayside saying there needs to be “more of a focus on developing supportive community services which are delivered by teams”.

Since revealing plans to resident the service, NHS Tayside has held a number of engagement services, including two evens in June where use to completed the Option Appraisal part of the redesign project.

The update states: “ The purpose of the event was to identify and develop options to provide General Adult Psychiatry (GAP) inpatient services on one site and on two sites in Tayside and consider options for future Learning Disability inpatient services as requested by Tayside NHS Board at its meeting in March.

“Each workshop was attended by around 90 people, including service users, carers, voluntary, third sector and partner organisations, as well as doctors, nurses, psychologists, Allied Health Professionals and support staff from NHS Tayside and Dundee, Angus and Perth & Kinross Health and Social Care Partnerships.”

Participants at these events developed list of option, which were then short-listed and then scored. Four options were closely scored, and the health board has said that between now and December they will now be “subject to further clinical appraisal, workforce review and financial appraisal of benefits”.

The four option are:

Option 3A - Single site provision for GAP acute admissions all at Carseview site (major) refurbishment required); All patients from Dundee, Angus and Perth & Kinross requiring inpatient treatment would be admitted to Carseview site; Improved pathway between Intensive Psychiatric Care Unit and Acute admissions if on a single site; Medical rotas out of hours would be required for Carseview site only. Medical cover required for MRH; Vacated ward on Susan Carnegie site available for alternative service; People with Learning Disability requiring inpatient beds would be admitted to Carseview Centre (major refurbishment would be required); Alternative accommodation / workshop provision would need to be found for the day services currently provided from Strathmartine; Learning Disability low secure patients cared for in Rohallion at MRH.

Option 4A - Moredun Ward at Murray Royal Hospital (MRH) would be relocated to the Carseview site (major refurbishment would be required at Carseview) Angus Acute admission beds remain in Mulberry on Susan Carnegie Site; People from Perth Kinross requiring acute admission would be admitted to Carseview site; Moredun ward at MRH would be a vacant ward and available for alternative use; People with Learning Disability requiring inpatient bed would be admitted to Carseview Centre (major refurbishment would be required); Alternative accommodation / workshop provision would need to be found for the day services currently provided from Strathmartine; Learning Disability low secure patients would be cared for in the Rohallion unit at MRH; Medical rotas out of hours still required for Susan Carnegie Centre and Carseview sites; edical cover required for MRH site.

Option 5A - Mulberry Ward at Susan Carnegie Centre would be relocated to Carseview site (major refurbishment would be required at Carseview); People from Angus requiring inpatient bed would be admitted to Carseview site; Mulberry ward at Susan Carnegie Centre would be a vacant ward available for alternative service use; Strathmartine Hospital would close and could be disposed of; People with Learning Disability requiring inpatient bed would be admitted to Carseview Centre (major refurbishment would be required); Alternative accommodation / workshop provision would need to be found for the day services currently provided from Strathmartine; Learning Disability low secure patients would be cared for in the Rohallion unit at MRH; Medical rotas OOHs needed for MRH and Carseview sites;

Option 8 - Patients from Dundee, Angus and Perth & Kinross admitted to Carseview site then transferred back to ‘step down’ / treatment wards in each locality; People with Learning Disability requiring inpatient bed would be admitted to Carseview Centre (major refurbishment would be required); Alternative accommodation / workshop provision would need to be found for the day services currently provided from Strathmartine; Learning Disability low secure patients would be cared for in Rohallion unit at MRH; Medical rotas would still be required for all three sites as patients in step down wards would still be acutely unwell; Doesn’t address nursing workforce challenges for provision of services across three sites.

The update also highlighted the next steps for NHS Tayside in the redesign project. The detailed report on the option appraisal process will go to the NHS Tayside Board today (Thursday, August 25), and they will be asked to confirm that they are satisfied with the process followed to identify the preferred options for future inpatient service provision.

The board will also be asked to approve the next steps, which will start with the development of an initial agreement stating the case for change with the necessary clinical, workforce and financial information to identify which of the four options is the most feasible and will deliver the aims of the programme to provide sustainable, high-quality, safe and effective care and treatment. This will be presented to NHS Tayside Board in December 2016.

After this is agreed there will then follow a three month period of wider stakeholder consultation in early 2017, and then a business case will be developed and will be presented before the Scottish Government Capital Investment Group in late spring or early summer 2017.

If it is all approved, a full business case will follow with a more detailed design and planning stages in late 2017.