Agenda item

That the update be noted.

The Chair welcomed Jonathan Falcus, Assistant Director of Community Services and Andrew Roach, Director of Mental Health & Learning Disabilities of Betsi Cadwaladr University Health Board (BCUHB) to the meeting.

Mr. Falcus, who was attending on behalf of the Area Director East, Rob Smith, gave a detailed update on work being undertaken in a number of areas to improve health and social care in Flintshire.  This involved collaborations with Social Services officers and representatives from Mental Health Services and the independent sector to produce a plan to identify improvements to help facilitate patient discharge from hospital.  Recommendations from this work would be shared with the Chief Executive of the BCUHB and the six North Wales authorities to promote the development of support to the independent sector and improve patient flow.

Information was also given on the expansion of Community Resources teams in Flintshire and Wrexham to develop a 24/7 response service to care in the community.  Merged funding streams and primary care development monies were being used to achieve this more coherent service which would enable capacity to respond to unscheduled events outside normal working hours.  The initiative involved recruitment of additional resources such as District Nurses and generic workers, as well as extending access to Occupational Therapists and Physiotherapists until 6/7pm on weekdays.  A further element was to develop a Frailty Assessment Unit which was a multi-disciplinary approach to creating a care plan in preparation for any potential crisis.  The introduction of hubs would enable patients to be assessed for their care needs.

The Chair said that a concern had been raised about smoking outside hospitals.  It was agreed that the Facilitator would forward this to Mr. Rob Smith for a response as he was Chair of the Smoking Cessation Group at BCUHB.

Councillor Hilary McGuill felt that the early intervention approach through the Frailty Assessment Unit could be ineffective, as patients generally needed hospital care at the point of such a crisis.  Mr. Falcus acknowledged that some patients’ needs were better addressed at district general hospitals, but there was clear evidence that the early assessment would benefit some other patients to identify potential options available if a crisis were to occur in consultation with families/carers.  In response to other queries, he confirmed that the Single Point of Access was now operational and that teams were in regular contact.  Explanation was also given on training/education to implement care plans with support from the Community Resources teams.

The Chair praised the services of Deeside Community Hospital and highlighted the importance of these facilities, including the new building in Rhyl, in caring for patients outside district general hospitals.  Mr. Falcus said that the transformation of Community Resources teams would give an opportunity to respond better to individuals’ needs and that pathway plans involved the use of community hospitals and ‘step-up/step-down’ beds.

Councillor Matt Wright welcomed the recruitment of additional District Nurses as this commitment had been made on the closure of community hospitals.  He sought clarification on how many would be recruited and the timescale involved, asking how these would link to GP services as seen with the new health centre model in Prestatyn.  Mr. Falcus spoke about a phased approach to the recruitment process, with current advertisements out for District Nurse posts and Occupational Therapists due to be advertised before Christmas.  The exact number of additional staff would depend on the working hours of those appointed, however it was known that an additional two Occupational Therapists and two Physiotherapists were being sought.  In total, it was hoped to recruit an extra 22 multi-disciplinary members to the Community Resources team in addition to recruitment for the Wrexham area to enable cross-area working.

Councillor Veronica Gay felt that community hubs were not likely to work in areas such as Saltney where services were linked with the Countess of Chester Hospital.  Mr. Falcus gave assurances that community services (mainly involving home care) would be equally accessible by all residents in Wales, including those with a GP based in England.

When asked about the proposed location of a Frailty Assessment Unit in Flintshire, Mr. Falcus would advise the Committee of the outcome once options had been explored.

Mr. Andrew Roach, who had recently been appointed as Director of Mental Health & Learning Disabilities, gave an update on the key developments in Mental Health Services.  Amongst the expectations detailed in the Special Measures improvement framework, challenging ambitions were being set in the Mental Health Strategy which was due for completion by March 2017.  The interim framework which set out the vision for Mental Health Services over the next three years would be shared with key partners, service users and carers in January to ensure it met the aspirations of all concerned.

Councillor Paul Cunningham relayed a concern about a patient being inappropriately placed on a Dementia ward which had impacted on their health.  Mr. Roach said that such cases were unacceptable and should not continue.

The changes were welcomed by Councillor David Healey who had concerns about the lack of beds available for individuals with mental health issues and the need for patients to have access to Welsh translators if needed.  He pointed out that placements outside the area meant additional travel for families which could have a negative effect on the patient’s health.  Mr. Roach said that acute beds in the locality were sought where possible, and that improved processes had led to a significant reduction in the number of out of area placements.  In response to calls for a rapid response team, Mr. Roach said that the transformation programme would look at the potential for a crisis intervention team involving pathways to avoid individuals being subject to a ‘revolving door’ process.

Councillor Cindy Hinds referred to lengthy delays at Accident & Emergency units and felt that patients with mental health issues should be able to access an alternative area.  Mr. Roach agreed that an appropriate place of safety should be provided and that investment was needed in psychiatric liaison services to signpost patients to support, however there was not enough capacity at the present time to fulfil those aims.

RESOLVED:

That the update be noted.