An independent report published this week supports proposals to reorganise mental health inpatient services across Lancashire.
The report from the National Clinical Advisory Team (NCAT) said that the proposals were “in line with good clinical practice” and commends the “huge amount of work that has gone into these plans over several years.”
The report has been commissioned by NHS North West as part of an assessment of existing major service change schemes across the region.
Its publication comes part way through a review of proposed changes to inpatient care following an extensive consultation process in 2006. The review aims to test the proposals against the government’s new rules on health service reconfiguration, which must demonstrate:
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support from GP commissioners;
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strengthened public and patient engagement;
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clarity on the clinical evidence base; and
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consistency with patient choice.
The proposed changes include reducing the number of inpatient facilities to establish a smaller number of new purpose-built inpatient sites. This was based on evidence that too many people were going into hospital and staying there because there were not enough suitable alternatives in their communities. The care most people with mental health problems need can be provided very effectively in communities rather than hospital. The consultation proposed that there should be more options and choices in the community for support and treatment when people have mental health crises in their lives. Not only do patients prefer to receive support in a community setting, where appropriate, but they have better mental health outcomes when they are supported by services delivered outside of hospital.
NCAT provides a pool of external independent clinical experts to support, advise and guide the local NHS on local service reconfiguration proposals to ensure safe, effective and accessible services for patients. The team spoke to a range of interested parties, including doctors, service users and staff representatives, as well as reviewing a range of documentation.
Their report highlights support for the “broad direction of travel” which is “in line with good clinical practice.” It points to the current inpatient facilities, which are “no longer fit for purpose”, with existing wards in district general hospitals mainly of “dormitory style with difficulties in ensuring separate space for men and women.”
“Moving to new inpatient services, built to a high standard with appropriate access to outside space and providing expert level of care can hardly be faulted,” the authors said.
The report also states that that people would “far rather receive care in a pleasant, clean and efficient service than be concerned about travel.”
However, the report recommends that further work is required to assess the impact of the overall programme as regards access to inpatient services, and also that a higher priority should be given to develop crisis facilities.
The review by all five Lancashire primary care trusts (PCTs), which is ongoing until February 2011, will also include retesting any new proposals against the government’s four rules on NHS service change.
Debbie Nixon, who works across Lancashire for all five PCTs as the strategic director for mental health, said: “We welcome the NCAT report which supports our proposals to improve mental health services across Lancashire.
“We will take the NCAT report’s recommendations into account as part of our current review of the 2006 consultation. This review aims to make sure the proposals still meet the clinical needs of patients. This is vital given the time which has elapsed since the consultation, the recent progress made in developing community mental health services, and the current economic environment.
“An initial report outlining the case for change with regard to mental health services will be going to the Lancashire PCT boards later this month. We will then consider what additional engagement or consultation we need to undertake.”
More information about the review, as well as a copy of the NCAT report, is available at http://www.lancashirementalhealth.co.uk/oct2010.htm.
