1
Adult General Psychiatry Inpatient Bed Provision
Consultation Document
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Contents
page
1. Introduction 3
2. What are adult general psychiatry inpatient services? 4
3. The proposal in more detail 5
4. The reasons for the proposed reduction in adult general psychiatry inpatient beds 4.1 Investment in community mental health services 4.2 Reduction in demand for inpatient care 4.3 Comparison with national recommendations 4.4 Financial impact
5 5 7 8 8
5. How this proposal might affect a) service users, their families and carers b) other LPT services and partner organisations c) LPT staff
9
6. The expansion of Eating Disorder Services 17
7. Conclusions 18
8. The consultation process 8.1 What has happened so far 8.2 How you can provide your views 8.3 What will happen when the consultation period ends 8.4 How LPT will provide feedback 8.5 Do you need this information in a different format?
19 19 19 20 20 21
Appendix 1: Comparison of LPT’s adult general psychiatry inpatient bed provision with the Royal College of Psychiatrists (RCP) recommended requirements
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Appendix 2: Explanation of terms used 24
Feedback form 26
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1. Introduction The purpose of this consultation is to seek your views on the proposal to
permanently reduce the number of adult general psychiatry inpatient beds provided
by Leicestershire Partnership NHS Trust, in response to additional investment in
the provision of community services and a reducing demand for inpatient
admissions. The proposal is to reduce the total number of adult general psychiatry
inpatient beds from 202 to 156, a reduction of 46 beds. In addition, this proposal
would make ward facilities available for an agreed expansion of eating disorder
beds.
A 14 week period of consultation on this proposal begins on 4 December 2006 and
ends on 9 March 2007. No decision will be made about the proposal until the end
of the consultation period, when everyone will have had an opportunity to
comment.
This consultation document has been widely circulated to service users, their
families and carers, staff working within LPT, voluntary sector organisations, local
authorities, Primary Care Trusts (PCTs) and other members of the health and
social care community.
The document explains the reasons for the proposed permanent reduction in adult
general psychiatry inpatient beds, how service users will be cared for with a
reduced number of beds and the potential impact of the proposal on people who
use inpatient services and our partner organisations.
You can provide your views on the proposal in a variety of ways (see section 8.2
for details). A feedback form is included which you may find helpful to record and
submit your comments about the proposal.
This document is available on the internet (www.leicspt.nhs.uk) and in paper copy.
It is also available in other formats on request (see section 8.5 for details).
There will be a number of public events held across Leicester, Leicestershire and
Rutland where you can find out more about this proposal and provide us with your
views. For further information about these events see section 8.2.
Leicestershire Partnership NHS Trust (LPT) is the provider of mental health and
learning disability services for people living in Leicester, Leicestershire and
Rutland. LPT is managing this public consultation. Once the period of consultation
has ended, the LPT Trust Board will receive reports that set out the views and
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comments obtained during the consultation process. The Trust Board will then
make a decision as to the way forward, having considered all of the views,
comments and feedback obtained.
There is an explanation of terms used in this document in Appendix 2.
2. What are adult general psychiatry inpatient services?
Adult general psychiatry inpatient services provide hospital care for people aged 16
to 65 years who require treatment for acute and very severe mental ill health.
Approximately half of these service users are detained in hospital under the Mental
Health Act 1983. People receiving treatment in one of LPT’s adult general
psychiatry inpatient units may be in hospital for periods of time that range from just
a few days to several months.
LPT’s adult general psychiatry inpatient services are provided at the Brandon Unit
(on the Leicester General Hospital site) and at the Bradgate Unit (on the Glenfield
Hospital site). The proposed reduction in inpatient beds would be at the Brandon
Unit.
Specialist inpatient provision for service users with an eating disorder would benefit
from this proposal.
However, this proposal would not affect the provision of other specialist inpatient
services for:
• liaison psychiatry
• forensic services
• perinatal services
• drug and alcohol services
• assertive outreach services
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3. The proposal in more detail There are two parts to the proposal, which together would lead to a permanent
reduction in adult general psychiatry inpatient beds from 202 to 156.
a. The permanent closure of Herrick Ward at the Brandon Unit. This ward has been closed on a temporary basis since December 2005, but it previously provided 30 beds.
b. The change in use of Stanford Ward at the Brandon Unit, with the loss of 16 adult general psychiatry inpatient beds, on an incremental basis.
Stanford Ward would instead provide an extra 8 inpatient beds for patients with an
eating disorder, making a total of 14 beds for this service. The number of beds for
the eating disorder service has currently been increased to 10 on a temporary
basis; this has reduced the number of adult general psychiatry beds by 9, leaving a
total of 15 such beds on Stanford Ward. (See section 6 for further details on the
expansion of eating disorder services.)
If the proposal is approved, it would be fully implemented as soon as possible after
1 April 2007.
4. The reasons for the proposed reduction in adult general psychiatry inpatient beds
4.1 Investment in community mental health services
In recent years there has been a national and local emphasis on providing more
community-based mental health services because research shows that people
prefer to be treated in the community rather than having to be admitted to hospital.
Within Leicester, Leicestershire and Rutland there has been additional investment
in developing new community mental health services such as Crisis Resolution
Teams, Assertive Outreach Teams, Early Intervention Teams and the Common
Mental Health Problems Service. There are now teams serving both Leicester City
and the Counties areas and the Common Mental Health Problems Service has
expanded so that it is now available from all General Practitioner surgeries.
This additional investment allows more patients to be seen and supported in a
community setting and the consequence has been a reduced demand for inpatient
care.
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Table 1 shows the extra money that has gone into the development and expansion
of community mental health services since 2004. This has been through additional
investment by Primary Care Trusts and investment by LPT through the redesign of
services, so that services continue to meet the changing needs and preferences of
service users. The requirement for enhanced provision of community services is
set out in the National Service Framework for Mental Health (Department of
Health, 1999) and in the White Paper ‘Our Health, Our Care, Our Say’ (Department
of Health, 2006).
Table 1: Funding for community mental health service developments 2003-04 to 2006-07
Service Funding Source*
2004-05 2005-06 2006-07
£000 £000 £000
PCT 1866 2898 3408 Crisis Resolution
LPT - 398 109
Total investment in Crisis Resolution Services
1866 3296 3517
PCT 562 1071 1071 Assertive Outreach
LPT 565 747 1041
Total investment in Assertive Outreach Services
1127 1818 2112
PCT 410 688 688 Psychosis Intervention & Early Recovery (PIER)
LPT - - 92
Total investment in PIER Services
410 688 780
PCT 710 957 957 Common Mental Health Problems Service (CMHPS)
LPT 705 566 759
Total investment in CMHPS 1415 1523 1716
* Primary Care Trust (PCT) funding provided through additional investment; LPT contribution
provided through funding released through service redesign.
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4.2 Reduction in demand for inpatient care
As more people are treated by these new community services, the demand for
inpatient admissions has reduced by approximately 34% since 2003. By
December 2005, when Herrick Ward closed on a temporary basis, the level of bed
occupancy on general psychiatry wards had fallen to 79% (excluding leave), which
is well within the maximum occupancy level of 95% recommended in the National
Service Framework for Mental Health. During the time that Herrick Ward has been
closed temporarily, the level of bed occupancy has been between 83-90%. The
effect of a further reduction in adult general psychiatry beds following the proposed
reconfiguration of Stanford Ward could potentially increase bed occupancy,
although the number of beds available would still be within the Royal College of
Psychiatrists recommendations (see section 4.3). Table 2 and Figure 1 show the
impact of these changes on LPT’s services.
Table 2: Number of inpatient admissions during period 2003-2006
2003-04 2004-05 2005-06
Total inpatient admissions 2298 2009 1516
% reduction in admissions between 2003-2006
34%
Figure 1: Adult inpatient bed occupancy rates
Note: Figures include general psychiatry and assertive outreach beds.
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94% 89% 80% 78% 78% 85% 84% 83% 84% 80% 80% 80% 80% 82% 79% 90% 86% 90% 89% 85% 83% 88% 83% 90%
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4.3 Comparison with national recommendations
LPT has compared the number of adult general psychiatry inpatient beds that it
provides with the recommended requirements set down by the Royal College of
Psychiatrists (RCP). This comparison is done on the basis of the number of
inpatient beds needed per 100,000 population. The population is ‘weighted’, or
adjusted, to reflect the particular level of need for mental health services within the
population of Leicester, Leicestershire and Rutland. ‘Weighting’ also allows for a
reliable comparison to be made with the RCP data.
The loss of 46 beds through the permanent closure of Herrick Ward and the
reconfiguration of Stanford Ward would mean that the number of beds provided by
LPT would be 29.6 per 100,000 population. This is at the middle of the RCP
recommended range of 25-33 beds per 100,000 population and would reflect the
efficient use of LPT’s resources.
Appendix 1 provides more detailed information on this comparison of Trust
inpatient provision
4.4 Financial impact
LPT, like all other NHS Trusts, is required to manage and operate its services as
efficiently as possible. Each year it is expected to achieve up to 2.5% efficiency
savings (equivalent to about £2.5 million) on a recurrent basis and to ‘break even’
at the end of the financial year. In recent years, although efficiency savings have
been achieved within each year they have not all been achieved recurrently. This
has resulted in LPT accumulating a funding gap of £7.3 million in 2006-07 that has
to be met through recurrent cost efficiency savings.
In this financial climate, LPT cannot afford to continue staffing and running
inpatient beds that are no longer required to meet the needs of the local
population. The proposed permanent closure of Herrick Ward and the
reconfiguration of Stanford Ward are put forward as the most appropriate way of
meeting LPT’s financial pressures whilst also addressing changes in demands for
services.
In a full year the savings from the permanent closure of Herrick Ward and the
reconfiguration of Stanford Ward would be around £1.2 million. If these savings
are not achieved through the proposal put forward in this consultation document, it
would be necessary to achieve equivalent savings through changes in some other
part of the Trust’s services.
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5. How this proposal might affect a) service users, their families and carers b) other LPT services and partner organisations c) LPT staff
Herrick Ward was closed on a temporary basis in mid December 2005 and has
remained closed since that time. In May 2005 the findings of a formal review of the
impact of this change were presented to the Trust Board and since that time LPT
has continued to monitor the situation and keep it under close review. LPT
therefore has detailed knowledge of the impact of the closure of Herrick Ward and
is in a good position to assess what further impact the reconfiguration of Stanford
Ward might have on adult general psychiatry inpatient services. The criteria used
to review the impact of the temporary closure of Herrick Ward were agreed by LPT
clinicians and Local Authority representatives. These same criteria are used for
the assessments in Tables 3 to 5.
Tables 3 to 5 set out an assessment of the potential effects of the proposals, what
the Trust has experienced in practice since Herrick Ward was temporarily closed,
and the measures that LPT has in place to reduce any potential negative
consequences or risks that could result from the proposal.
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Table 3: How this proposal might affect service users, their families and carers
Potential effect What we are experiencing in
practice
LPT actions to reduce any potential
negative consequences or risks
1. A reduction in the number of adult
general psychiatry inpatient beds as
a result of the permanent closure of
Herrick Ward and the
reconfiguration of Stanford Ward
could increase the occupancy
levels on the remaining 7 wards
providing this type of inpatient care.
During January – September 2006
when Herrick Ward has been closed
temporarily, the bed occupancy levels
across all adult inpatient services have
been between 83-90%, which is within
the maximum occupancy level of 95%
recommended in the National Service
Framework for Mental Health.
The LPT ‘Use of Bed Policy’ has been
reviewed and changes made to clarify
roles and responsibilities for bed
management.
A Bed Management Group meets
weekly to monitor and review
arrangements in relation to clinical,
social and financial impact.
There is a weekly review of available
beds by the Modern Matron.
2. A potential increase in the number
of serious adverse events due to a
higher concentration of severely ill
people on hospital wards and
people with higher risks being
treated in the community rather
than in hospital.
There has been no increase in the
number of serious adverse events.
A Bed Management Group meets
weekly to monitor and review
arrangements in relation to clinical,
social and financial impact.
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Potential effect What we are experiencing in
practice
LPT actions to reduce any potential
negative consequences or risks
3. A potential increase in the number
of incidents requiring the
Emergency Response Team to
intervene.
There is no evidence of an increase in
demand for the Emergency Response
Team.
A Bed Management Group meets
weekly to monitor and review
arrangements in relation to clinical,
social and financial impact.
4. The likelihood of service users
being transferred from one ward or
unit to another could increase and
affect their continuity of care.
In the first 3 months following the
temporary closure of Herrick Ward
there was an increase in the number of
transfers between units and wards.
This has now reduced between units
but remains higher than previously
between wards in individual units.
Some service users may be concerned
about leave arrangements because of
the periodic pressure on beds.
The LPT ‘Use of Bed Policy’ has been
reviewed and changes made to clarify
roles and responsibilities for bed
management; this includes LPT’s
transfer of patients policy.
A Bed Management Group meets
weekly to monitor and review
arrangements in relation to clinical,
social and financial impact.
The locality focus of each ward within
the Brandon Unit would be realigned to
minimise the transfer of service users
between wards and to ensure equity of
service for each locality served.
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Potential effect What we are experiencing in
practice
LPT actions to reduce any potential
negative consequences or risks
5. The disruption to services and staff
could potentially affect the
continuity of care and rate of
recovery of service users.
Initial levels of disruption have reduced,
but not gone away entirely.
The length of stay for service users has
remained the same following the
temporary closure of Herrick Ward.
A Bed Management Group meets
weekly to monitor and review
arrangements in relation to clinical,
social and financial impact.
There is a weekly review of available
beds by the Modern Matron.
6. A reduced number of adult general
psychiatry inpatient beds could
potentially mean that if no bed were
available a service user might need
to be treated out of area.
This situation has not occurred since
Herrick Ward closed temporarily in
December 2005.
The LPT ‘Use of Bed Policy’ has been
reviewed and changes made to clarify
roles and responsibilities for bed
management; this policy includes
LPT’s procedure for out of area
transfers.
A Bed Management Group meets
weekly to monitor and review
arrangements in relation to clinical,
social and financial impact.
There is a weekly review of available
beds by the Modern Matron.
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Table 4: How this proposal might affect other LPT services and partner organisations
Potential effect What we are experiencing in
practice
LPT actions to reduce any potential
negative consequences or risks
1. Increased pressure on community
services as fewer people would be
treated in hospital, with the potential
for deterioration in a service user’s
mental health due to reduced
contact and monitoring
There is no evidence of any negative
impact on service user’s mental health
as a result of being treated in the
community.
The Crisis Resolution Teams have
been a major factor in achieving good
treatment outcomes for community
service users.
The caseloads for community mental
health team staff are monitored
regularly.
2. Crisis Resolution Team Services
may not be able to maintain or
improve the reduction in demand
for inpatient admission and
continued provision of home
treatment.
There is no evidence to suggest that
Crisis Resolution Teams are struggling.
In fact, they have been a major factor
in achieving good treatment outcomes
for community service users.
Work has taken place with the Crisis
Resolution Teams to increase their
focus on supporting early discharge
from hospital and further developing
their gate-keeping role for admissions,
which includes home treatment
interventions. This reflects the recent
Department of Health guidance on
Crisis Resolution Team roles in gate-
keeping and early discharge (October
2006).
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Potential effect What we are experiencing in
practice
LPT actions to reduce any potential
negative consequences or risks
3. Increased pressure on LPT day
services could affect the ability of
day service staff to provide service
users with appropriate
interventions.
There is no evidence that this has
happened since Herrick Ward was
temporarily closed.
4. Tighter management of referrals for
inpatient care could potentially
adversely affect working
relationships between secondary
and primary care.
No concerns have been raised by
primary care colleagues following the
temporary closure of Herrick Ward.
A Bed Management Group meets
weekly to monitor and review
arrangements in relation to clinical,
social and financial impact.
5. Increased pressure on Care Co-
ordinators and Social Workers to
arrange domiciliary packages of
care for service users being
discharged from hospital.
There is no evidence that this has been
experienced since Herrick Ward was
temporarily closed.
Consultants carry out regular reviews
of service users who might be ready to
go on leave or be discharged from
hospital.
6. Increased pressure on social care
staff to identify accommodation or
residential care placements and the
associated funding for service users
being discharged from hospital.
There is no evidence that this has been
experienced since Herrick Ward was
temporarily closed.
Consultants carry out regular reviews
of service users who might be ready to
go on leave or be discharged from
hospital.
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Table 5: How this proposal might affect LPT staff
Potential effect What we are experiencing in
practice
LPT actions to reduce any potential
negative consequences or risks
1. An increase in the levels of stress
experienced by health and social
care staff on wards and in the
community due to a change in
working practices, which could
result in increased levels of staff
sickness and absence from work.
There is no evidence of any significant
increase in levels of staff sickness and
absence. Staff are reporting increased
levels of work-related stress, which
may, or may not, be related to this
proposal.
The temporary redeployment of
Herrick Ward staff was carried out in a
way that prioritised keeping distress to
the staff at an absolute minimum.
The caseloads for community mental
health team staff are monitored
regularly.
2. The reduced number of staff
working in the Brandon Unit could
mean that fewer trained staff are
available to be part of the
Emergency Response Team.
There are fewer trained staff available
to support the Emergency Response
Team, but this has not resulted in an
increase in serious adverse events.
A Bed Management Group meets
weekly to monitor and review
arrangements in relation to clinical,
social and financial impact.
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Potential effect What we are experiencing in
practice
LPT actions to reduce any potential
negative consequences or risks
3. Staff may need to spend more time
on bed management that could be
spent on direct patient care.
Evidence does show that staff are
having to spend an increased amount
of time on bed management.
The LPT ‘Use of Bed Policy’ has been
reviewed and changes made to clarify
roles and responsibilities for bed
management.
A Bed Management Group meets
weekly to monitor and review
arrangements in relation to clinical,
social and financial impact.
There is a weekly review of available
beds by the Modern Matron.
Consultants carry out regular reviews
of service users who might be ready to
go on leave or be discharged from
hospital.
4. Staff could be made redundant as a
result of the proposed changes.
Following the temporary closure of
Herrick Ward all staff were redeployed
to work in other LPT services.
LPT does not anticipate any staff
redundancies as a result of the
proposed permanent closure of Herrick
Ward or the reconfiguration of Stanford
Ward.
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6. The expansion of Eating Disorder Services
The clinical eating disorders (anorexia nervosa, bulimia nervosa, binge eating
disorder, atypical eating disorders and other related syndromes) are an important
public health problem especially in younger women. Eating disorders are often
chronic and are associated with substantial morbidity and one of the highest
mortality rates amongst the psychiatric disorders.
LPT’s eating disorders service is a nationally recognised specialist service that
offers assessment and treatment for people over 16 years. It provides a range of
psychotherapeutic treatments through outpatient, day and inpatient services.
The service is currently available to people living in Leicester, Leicestershire and
Rutland, but also takes referrals from neighbouring counties and occasionally from
elsewhere in the country. The expansion in the total number of Eating Disorder
Services beds from 6 to 14 beds would enable LPT to make this specialist
expertise available to patients from a wider geographic area and particularly from
the East Midlands region (Derbyshire, Nottinghamshire, Lincolnshire and
Northamptonshire).
Four of the 14 eating disorder beds would continue to be designated for use by
patients from Leicester, Leicestershire and Rutland.
Proposals for the development of a regional eating disorders service have been the
subject of a separate consultation involving other mental health Trusts and
commissioners in the NHS East Midlands Strategic Health Authority area and the
Eating Disorders Association. As a result, Leicester was jointly identified as the
preferred location for the development of a regional service.
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7. Conclusions
Leicestershire Partnership NHS Trust is proposing to permanently reduce the
number of adult general psychiatry inpatient beds it provides, in response to
additional investment in the provision of community services and a reducing
demand for inpatient admissions. The proposal is to reduce the total number of
adult general psychiatry inpatient beds from 202 to 156, a reduction of 46 beds.
This would be achieved through:
a. The permanent closure of Herrick Ward at the Brandon Unit. This ward has been closed on a temporary basis since December 2005, but it previously provided 30 beds.
b. The change in use of Stanford Ward at the Brandon Unit, with the loss of 16 adult general psychiatry inpatient beds, on an incremental basis.
Stanford Ward would instead provide an extra 8 inpatient beds for patients with an
eating disorder, making a total of 14 beds for this service.
LPT’s review of the impact of the temporary closure of Herrick Ward has shown
that this is a manageable change, especially when supported by the bed
management and policy reviews introduced by LPT. LPT is confident that the
impact on adult general psychiatry inpatient services as a result of the
reconfiguration of Stanford Ward can also be managed successfully under these
processes.
LPT is required to provide a range of community and inpatient services and to do
this in a balanced and efficient a way that:
• continues to meet the needs and aspirations of service users and carers;
• makes efficient use of public money; and
• moves mental health service provision forward in the agreed strategic direction
towards greater community provision.
There is a real change in the way people use mental health services, following the
investment in community services over the last 2-3 years. There is now less
demand for inpatient care and LPT has to take this change in demand into account
in planning services and in redistributing its financial investment in service
provision, so that the services that are available benefit the greatest number of
people.
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8. The consultation process
This consultation document is produced in accordance with the Cabinet Office
‘Code of Practice on Consultation’.
The 14 week period of consultation begins on
4 December 2006 and ends on 9 March 2007.
8.1 What has happened so far
This consultation document has been widely circulated to service users, their
families and carers, staff working within LPT, voluntary sector organisations, local
authorities, Primary Care Trusts (PCTs) and other members of the health and
social care community. Service user and carer groups, advocacy services,
Members of Parliament and the local media have also been informed.
Arrangements are being made for this proposal and consultation process to be
considered by the LPT Patient and Public Involvement Forum and also the
Leicestershire, Leicester and Rutland Health Overview and Scrutiny Committee.
The Overview and Scrutiny Committee is a local authority committee with
responsibility for monitoring the activities, particularly in relation to service changes
and consultation, of local health services.
8.2 How you can provide your views
We are seeking your views by:
• Arranging public meetings that anyone may come along to, where we can
discuss these proposals. The dates and venues for these meetings will be
publicised shortly.
• Talking with service user and representative groups to ensure that the views of
patients, their families and carers are actively sought and considered.
• Arranging meetings with LPT staff to discuss the proposals. The meeting dates
and venues will be publicised shortly.
• Attending meetings with health, social services and voluntary sector
organisations at their request.
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• Offering people the opportunity to provide their views by telephone or fax to
PALS – the Patient Advice and Liaison Service. The service can be contacted
at: telephone 0116 225 6647; mobile/text 0791 720 2647.
• Asking all interested parties to complete the enclosed feedback form and return
it to Leicestershire Partnership NHS Trust by 9 March 2007.
The feedback form should be returned to:
Communications Department
Leicestershire Partnership NHS Trust
George Hine House
Gipsy Lane
Leicester
LE5 0TD
• You can also write to us at the address above or e-mail us at
Additional copies of both this consultation document and feedback form are
available from the address above or from our web site at www.leicspt.nhs.uk.
8.3 What will happen when the consultation period ends
Once the consultation period has ended, the Trust Board of Leicestershire
Partnership NHS Trust will receive a report that brings together the views and
comments received during the process. The report will identify organisations and
groups that have contacted the Trust, but it will not identify individuals.
The Trust Board will then make a decision as to the way forward having considered
all of the views, comments and feedback received. The report will be discussed
and the decision made at the Trust Board meeting on 22 March 2007.
8.4 How LPT will provide feedback
Copies of the consultation report considered by the LPT Trust Board and the
decision reached by the Board will be available on the Leicestershire Partnership
NHS Trust web site (www.leicspt.nhs.uk). Paper copies will also be available on
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request from LPT from the contact points (telephone, e-mail, address) given in
section 8.2 of this consultation document.
8.5 Do you need this information in a different format?
This information can be provided in Braille, audio tape, disk, large print or in other languages on request.
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Appendix 1: Comparison of LPT’s adult general psychiatry inpatient bed provision with the
Royal College of Psychiatrists (RCP) recommended requirements
Adult Mental Health - Population Data - Based on Registered Population by Primary Care Trust
16-64 Population MINI Index* Weighted Population
Adult City 232400 1.014 235654
Adult Counties 425000 0.684 290700
Total 657400 526354
* The MINI index is the Mental Illness Needs Index. It facilitates a ‘like for like’ comparison of figures across
different population areas. It is based on population data and levels of deprivation. An ‘average’ MINI index would be 1.0; a figure higher than 1.0 indicates higher levels of deprivation and mental health need and a figure lower than 1.0 signifies lower levels of deprivation and mental health need.
continues over
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Adult Mental Health - Movement in General Psychiatry Bed Numbers
1 2 3 4 5 6 7
Pre Herrick
Early 2005
Beds per
100k
Weighted
Population
After
Herrick
temporary
Closure
Dec-05
Beds per
100k
Weighted
Population
Increase
in Eating
Disorders
(6 to 14)
Beds per
100k
Weighted
Population
Adult City 68 28.9 68 28.9 68 28.9
Adult Counties 134 46.1 104 35.8 88 30.3
Total general psychiatry 202 38.4 172 32.7 156 29.6
Liaison 4 39.1 4 33.4 4 30.4
Forensic 5 40.1 5 34.4 5 31.3
Mothers with Babies 3 3 3
Drugs and Alcohol 6 6 6
Eating Disorders 6 6 14
Total on AMH Wards 226 196 188
1. Does not include Treatment and Recovery beds
2. RCP recommendations for the number of adult general psychiatry mental health beds is from 25-33 beds per 100,000 weighted population.
These are taken from RCP occasional paper (OP55) published in October 2002.
3. The RCP recommendations are based on the assumption that alternatives to admission exist e.g. intensive home treatment, crisis resolution,
assertive outreach, acute day care.
4. The RCP norms are for adult weighted population 17-64 (LPT weighted population above is for 16-64)
5. RCP occasional paper suggests (by omission) that liaison psychiatry and local forensic beds should be counted as acute beds.
Other specialist beds are individually mentioned
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Appendix 2: Explanation of terms used
Assertive Outreach Teams
A new intensive care service provided for people living in the community. It is
designed to provide person centred care for a small number of individuals with
serious mental illness, who may find it particularly difficult to engage with traditional
services.
Common Mental Health Problems Service
The service offers patients access to consultation and psychological treatment at
their local doctor’s surgery. The service is provided by Practice Therapists who are
qualified mental health professionals providing talking treatments for people
suffering with a common mental health problem such as mild forms of depression,
stress and anxiety.
Crisis Resolution Teams
A new service providing mental health assessment and treatment for people at
times of crisis. The team assesses the best way of meeting a person’s mental
health needs, which may be a stay in hospital or it may be intensive treatment at
home as an alternative to inpatient care. The team can also support earlier
discharge from hospital by providing intensive support at home.
Drug and alcohol services
Mainly community based services to help people with drug or alcohol abuse
problems. LPT has 6 inpatient beds for patients undertaking alcohol detoxification.
Early Intervention Teams
A service for young people aged 14-35 who are experiencing psychosis for the first
time. The aim is to provide treatment as early as possible to minimise the likelihood
of psychosis happening again.
Forensic services
Community and inpatient mental health services for people who have come into
contact with the criminal justice system.
Leicestershire Partnership NHS Trust (LPT)
Local providers of mental health and learning disability services.
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Liaison psychiatry
Provides mental health support for people who are in hospital primarily because of
a physical health problem, but who also require mental health care.
Patient Advice and Liaison Services (PALS)
Provides information, advice and support to help patients, families and their carers.
Perinatal services
Service for mothers with young babies who require mental health care, for example
for severe post-natal depression.
Primary Care Trust (PCT)
Organisation responsible for the health of the local community.
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Adult General Psychiatry Inpatient Bed Provision
FEEDBACK FORM (3 pages)
We are keen to know the views of individuals and groups about the proposals put
forward in this document. Please provide your views by 9 March 2007.
1. Do you support the proposal to reduce the number of adult general
psychiatry inpatient beds from 202 to 156 through
a. The permanent closure of Herrick Ward at the Brandon Unit. This ward has been closed on a temporary basis since December 2005, but it previously provided 30 beds.
b. The change in use of Stanford Ward at the Brandon Unit, with the loss of 16 adult general psychiatry inpatient beds, on an incremental basis.
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2. If you do not support the proposal set out in question 1, what alternative
way would you like to suggest for making efficiency savings to the
equivalent value of £1.2 million?
3. Are there any other comments that you would like to make about the
proposals in this consultation?
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4. About You
We would find it very useful to know who has responded to this consultation so we
can be sure we have received the views from a wide range of people. Your
comments will still be considered if you do not fill in this section.
(a) Did you fill in this feedback form as an individual or on behalf of a group?
� As an individual � On behalf of a group
If you filled this in as an individual, please tell us which town or village you live
in.
If you filled this in on behalf of a group, please tell us the name of the group and
the area it covers.
(b) Are you a user of mental health services or a carer/family member of someone
who uses mental health services?
� Yes, I am a service user
� Yes, I am a carer/family member
� No
(c) Are you a member of LPT staff?
� Yes, I work for LPT � No, I do not work for LPT
Thank you very much for taking the time to complete this feedback form.
Please return it to:
Communications Department Leicestershire Partnership NHS Trust George Hine House Gipsy Lane Leicester LE5 0TD
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