Purpose: Briefing from Tees, Esk & Wear Valleys NHS Foundation Trust on the temporary closure of the 13 bed in-patient unit for people with mental health conditions who are of working age

Considered: A briefing paper provided by Naomi Lonergan, Director of Operations North Yorkshire and York at Tees, Esk & Wear Valleys NHS Foundation Trust, covering the areas of York and Selby.  The briefing provided an update position regarding Esk Ward (a 13-bed female ward for patients requiring acute assessment and treatment for mental health), and the service ability to sustain the safety of the ward remaining open.

At the meeting Naomi Lonergan confirmed the ward closed on 12 November 2021 and that patient care and treatment episodes were completed for the majority of patients prior to the closure to prevent the need for those patients to be moved to a different provision. Only one out of area patient was required to move which was planned to happen anyway.

She also confirmed that the significant gaps in the senior roles delivering care and treatment across across nursing, medical and psychology, were a key element in the decision to temporarily close the ward - ward care was delivered on a multi-disciplinary team basis so consideration was not only given to nursing levels.  She also drew attention to the different options explored e.g. reducing the number of beds.

It was noted that daily meetings were taking place to look at all of the patients who would ordinarily receive their care from Esk Ward, to ensure they remained connected to their local community, with the intention of discharging them safely back home as soon as possible with adequate support.

Naomi Lonergan went on to confirm that the ability to retain and recruit staff into the adult wards at Cross Lane Hospital had been a revolving issue for several years, and she provide details on:

·         The actions previously taken to try and address their staffing issues

·         Their ongoing programme of focussed recruitment activity in Scarborough.  This included information on an ongoing international recruitment project, which was expected to deliver results by Spring 2022, with five new qualified members of staff to date and several more scheduled to be interviewed.

·         The development of senior nurse roles, with a proposal to introduce a nurse consultant type role, which it was hoped would deliver a better infrastructure to maintain care and treatment across the area.  It was noted it would also provide a career pathway and progression for nursing staff.

·         A new recruitment and retention premium, introduced in September 2021 as a pilot to attract people into Esk Ward and Danby Ward

·         The exploration of alternative ways of working with partners in the voluntary sector to improve the delivery of mental health care

County Councillor Liz Colling queried the long-term prognosis for the Ward and whether there were similar issues in other areas served by the Trust.  In response, the Trust’s medium to long term plans to ensure a sustainable workforce were outlined.  For example, whilst there were currently challenges around qualified staff and key professionals for the ward, the Trust had been successful in recent years in encouraging less senior staff to undertake degrees and upskill, thereby creating a pipeline of staff  for the future. Coventry University was also now delivering nurse training for the area, as was York St John University.  In addition, it was confirmed that the workforce issues outlined were also being experienced nationally, and that the Trust were dealing with similar recruitment concerns in the Harrogate area.

In response to other questions from Members, Naomi Lonergan confirmed:

·         There were currently five patients who would ordinarily have been in Esk Ward, who were now being supported elsewhere.  

·         The closest alternative provision was in York, followed by Middlesbrough, and by exception in Durham and Darlington.

·         Bed occupancy in mental health wards was much higher now nationally than previously seen pre-Covid. At times in recent months, 100% bed occupancy had been exceeded and the mental health forecast for the next five years was a continued increase in inpatient need.

·         From mid 2021, the situation with the Ward was being constantly reviewed, and mitigations and contingency plans were put in place, until eventually in October 2021 the decision being reached to temporarily close the Ward for six months.

·         Six months was considered an adequate length of time to address the recruitment issues across the multi disciplinary team.

·         A communications plan was in place to keep stakeholders, partners and the public updated.

The Chairman thanked Naomi Lonergan for attending the meeting and the recorded his thanks to the Chairman of the Scrutiny of Health Committee for bringing the issue to the Committee’s attention.

Resolved:  That the update be noted.