Mental Health and Learning Disability Services Redesign Transformation Programme Summary Consultation Document NHS Tayside and the three local Integration Joint Boards provide healthcare to people in Tayside (Angus, Dundee and Perth & Kinross). This document sets out proposals to redesign NHS Tayside Mental Health and Learning Disability Services and invites you to respond with your views. The consultation will run from 3 July to 3 October, 2017.
Mental Health and Learning Disability Services Proposal Introduction NHS Tayside and the three local Integration Joint Boards are proposing to make changes to how and where we deliver our General Adult Psychiatry (GAP) and Learning Disability (LD) inpatient services. This is to make sure we can provide a service that is safe and sustainable and will better meet the needs of the population of Tayside. It is also an opportunity to ensure that our staff, budget and buildings are used more fairly, effectively and efficiently. GAP inpatient services deliver treatment and care for patients in the most acute and vulnerable stage of mental illness. People should be treated in an inpatient setting only when their illness cannot be managed by either GPs or by mental health teams based in the community. LD services provide assessment and treatment of patients with learning disability and severe mental health and/or behavioural problems, patients with risky behaviours and those requiring long term care. 2
Why do services need to change? NHS Tayside provides healthcare to just under 500,000 people and has a strong track record in delivering high-quality healthcare and pioneering patient safety programmes. Our existing GAP and LD inpatient services have many strengths and we know our staff provide high quality care and support to service users, carers and families. However, like all health boards in Scotland, we are facing significant challenges, and can t keep delivering services the way we have in the past. We need to adapt our services to meet the future needs of the population. Patient safety is our overriding priority and to ensure we can continue to deliver a high quality of care, it has been necessary to look at how we provide these services and alternative models of care. Reasons for the proposed change Our clinicians have raised concerns about our ability to safely maintain three GAP acute admission inpatient units and two LD inpatient sites, due to a national shortage of medical and nursing staff which is not likely to change in the short or long term More than a third of our GAP nursing workforce and over half of our LD nurses will be eligible to retire within the next five years A third of our consultant workforce is made up of locums or those due to retire within the next five years and we have been unable to fill vacant consultant posts The ageing environment at Strathmartine does not meet the needs of LD patients, especially those who are in hospital for longer periods 3
How GAP and LD services are currently delivered Most people with a mental health problem are treated at home or in the community. When it is no longer possible to do this safely, a patient will be admitted to hospital. Approximately only 6% of people who access our mental health services each year need hospital care. GAP acute admissions have been provided across three sites Mulberry ward at the Susan Carnegie Centre in Angus, Moredun ward in Murray Royal Hospital, Perth, and two wards in the Carseview Centre in Dundee. Since February of this year, the Mulberry ward has been provided from Carseview on an interim basis due to a shortage of junior doctors, making it impossible to sustain safe services across three sites. The LD assessment unit is at Carseview Centre and all other LD inpatient services are based at Strathmartine on the edge of Dundee. What are we proposing to change? Our consultants, doctors, nurses and other members of the multidisciplinary team are leading this proposed change and they have already been discussing with other clinicians, managers, service users, carers, voluntary sector representatives and staff how services can be delivered. There have been lots of conversations, events and meetings to look at a number of options and explore what mental health and learning disability services need to deliver in the future for the people of Tayside. A wide range of participants have been involved in reviewing the pros and cons of each option put forward by the clinical teams. The preferred option was then presented to the Board of NHS Tayside, and Angus, Dundee and Perth & Kinross Integration Joint Boards, who agreed that the public should be consulted on the following proposal: GAP acute admissions to be provided from four wards at Carseview Centre in Dundee LD inpatient services to be provided from three wards at Murray Royal Hospital in Perth 4
What do the proposed changes mean for patients/you? If you need to be admitted for GAP inpatient services you will go to Carseview Centre in Dundee and will remain there until the end of your inpatient stay, no matter where you live in Tayside Following discharge from hospital you will be supported by local community mental health services in your own area If you need LD inpatient care you will go to Murray Royal Hospital in Perth and will remain there until the end of your inpatient stay, no matter where you live in Tayside Following discharge from hospital you will be supported by local community learning disability services in your own area What are the benefits for patients? We will create centres of excellence for GAP and LD services to ensure we provide high quality care for patients which is safe, sustainable and consistent across services The Intensive Psychiatric Care Unit (IPCU) will be located on the same site as all GAP acute admission beds reducing the need to travel between sites for a period of intensive treatment Community services will be redesigned to provide enhanced care and treatment from GP practices to specialist care and third and voluntary sector organisations with the aim of preventing admissions to hospital LD inpatients will benefit from significantly improved facilities at Murray Royal Hospital 5
What will not change? In most cases the same staff will deliver care and treatment The Intensive Psychiatric Care Unit (IPCU) will continue to be provided as a Tayside-wide service at Carseview Centre in Dundee The Tayside-wide GAP Complex Care and Rehabilitation inpatient services will continue to be provided at Murray Royal Hospital in Perth The Substance Misuse inpatient service will continue to be provided as a Tayside-wide service at Murray Royal Hospital in Perth The Regional Medium Secure Forensic inpatient service will continue to be provided at Rohallion Secure Care Clinic at Murray Royal Hospital in Perth. The Tayside-wide Low Secure Forensic services will also continue to be provided from the Rohallion Secure Care Clinic at Murray Royal Hospital in Perth. There will be no change to Psychiatry of Old Age (POA) Services or Child and Adolescent Mental Health Services (CAMHS) 6
Next steps How to find out more There is a full consultation document which provides further details on everything covered in this summary plus additional information. It includes more on the background reasons for the need to change, overview of current services, how local people have been informing the process, potential impact and how it would be addressed and a description of how options were selected, developed and appraised. A copy of the full consultation report is available electronically on our website at www.taysidementalhealthredesign.scot.nhs.uk or if you would prefer a printed copy you can write to us freepost at Public Involvement, Tayside NHS Board, Freepost SC0 6181, Dundee, DD3 8ZR, call 0800 7836 110 or email mhldredesign.tayside@nhs.net 7
Tell us your views You can share your views with us in a range of ways Go to www.taysidementalhealthredesign.scot.nhs.uk where you will find lots of extra information about our proposal and the latest updates as our consultation moves forward, including your most frequently asked questions. Please also fill in our online questionnaire to help us get as many views as possible. You can email us with your views or questions at mhldredesign.tayside@nhs.net You can phone us with the views or questions on 0800 7836 110 You can also submit your views by writing freepost to Public Involvement, Tayside NHS Board, Freepost SCO 6181, Dundee, DD3 8ZR Get involved We will be hosting a number of public engagement events to give everyone the chance to have their say. Details of events will be available at www.taysidementalhealthredesign.scot.nhs.uk Follow us on facebook www.facebook.com/nhstayside Follow us on Twitter @NHSTayside 8
If you would like this information about proposals for mental health and learning disability services in Tayside in your own language, please contact: Arabic: :ةيسفنلا ةحصلا تامدخ ةصاخلا كتغلب Tayside يف ملعتلا تابوعصو ةيسفنلا ةحصلا تامدخ تاحرتقم نع تامولعم يف بغرت تنك اذإ :ب لاصتالا ىجر يف كب Polish: Usługi związane ze zdrowiem psychicznym: Aby otrzymać te informacje na temat propozycji usług zawiązanych ze zdrowiem psychicznym i niepełnosprawnością intelektualną w Tayside we własnym języku, należy skontaktować się z: Punjabi: ਮ ਨਸ ਕ ਸ ਹਤ ਸ ਵ ਵ : ਜ ਤ ਸ ਟ ਸ ਈਡ (Tayside) ਵ ਖ ਮ ਨਸ ਕ ਸ ਹਤ ਅਤ ਸ ਖਣ ਸਬ ਧ ਅਸਮਰਥਤ ਸ ਵ ਵ ਬ ਰ ਸ ਝ ਵ ਬ ਬਤ ਇਹ ਜ ਣਕ ਰ ਤ ਹ ਡ ਆਪਣ ਭ ਸ਼ ਵ ਚ ਪ ਰ ਪਤ ਕਰਨ ਚ ਹ ਦ ਹ, ਤ ਕ ਰਪ ਕਰਕ ਇਹਨ ਨ ਲ ਸ ਪਰਕ ਕਰ : Russian: Услуги в области психической помощи: Если вам нужна информация о доступных услугах в области психической помощи и нарушения обучаемости в Тейсайде на вашем родном языке, свяжитесь с нами: Simplified Chinese: 心理健康服务 : 如果您希望这一关于推荐 Tayside 中心理健康和学习障碍服务的信息以您自己的语言提供, 请联系 : Traditional Chinese: 心理健康服務 : 如果您想要您自己語言版本的 Tayside 心理健康和學習障礙提案, 請聯絡 : Urdu: ذ نی صحت سے متعلق خدمات : ٹائن سائڈ ميں ذ نی صحت اور لرننگ ڈس ايبلٹی كی خدمات كے بارے ميں تجاو يز سے متعلق يہ معلومات اگر آپ كو اپنی ز بان ميں دركار ہو تو برائے مہر بانی رابطہ كر يں : : تامدخ قلعتم ےس تحص ینہذ رگا تامولعم ہی قلعتم ےس زیواجت ںیم ےراب ےک تامدخ یک یٹلبیا سڈ گننرل روا تحص ینہذ ںیم ڈئاس نئاٹ : ںیرک ہطبار ینابرہم ےئارب وت وہ راکرد ںیم نابز ینپا وک پآ mhldredesign.tayside@nhs.net 0800 7836 110 This document is also available in large print and other formats upon request. 9