Agenda item

Provisional Item: North East London NHS Foundatin Trust officers will summarise their future plans in response to the inspection report by the Care Quality Commission (attached).

The NELFT Integrated Care Director confirmed that each borough Health Overview and Scrutiny Committee had scrutinised the outcome of the Trust’s inspection by the Care Quality Commission (CQC) that had taken place in early 2016. The Brookside unit for young people had been rated as inadequate and other concerns had been over care planning and risk assessment on mental health inpatient wards.

The Brookside unit had been closed for a period in response and the model of care employed there had been fundamentally changed. A new model of service had now been agreed with commissioners – NHS England. The CQC had revisited the refurbished unit in October 2016 and was now happy with the services at Brookside although the unit was still closely monitored. It was clarified that the unit accommodated people aged 12-18 years and covered all four Outer North East London boroughs. The unit was based at Goodmayes Hospital. A shortage of adolescent mental health beds nationally meant there had been pressure on the unit to admit patients from elsewhere. This had improved however and patients were mainly from the Outer North East London boroughs. Councillor Sweden congratulated the NELFT officer on the improvements at Brookside. 

Most CQC recommendations had now been implemented by NELFT with the remainder in the process of being completed. Quality improvement work was under way to address the CQC findings around care planning and risk assessments. Work to eliminate ligature risks in the in-patient mental health unit would be completed by spring 2018 and the unit would be closed while this work was carried out.

The CQC would carry put a further inspection on the ‘well led’ domain in October 2017 when some other areas would also be assessed that had previously been found to need improvement.

It was hoped that the changes made would also improve corporate governance and vacancy rates at the Trust had been addressed. The exact position re the registration of non-executive directors at the Trust in relation to the Fit and Proper Person Test would be confirmed by officers.

A ward at Goodmayes that catered for patients with learning disabilities had originally been closed due to the presence of a very challenging patient on the ward, leading to safety issues for other patients. The unit was now open to admissions but a written response would be provided.

Officers agreed that earlier intervention in mental health conditions was usually better for patients. The Trust’s Early Intervention in Psychosis service had a target of establishing a care package for psychosis within two weeks of a patient’s referral. The Trust had also established the Improving Access to Psychological Therapies service which provided talking therapies for conditions such as anxiety and depression for patients who did not require secondary care.

The work to eliminate ligature risks had prioritised the higher risk, acute mental health wards. Whilst this risk could never be removed entirely, the Trust did aim to nurse patients in more ligature-free areas.

NELFT had community provision for eating disorders although it did not offer in-patient beds for this condition. Work would be undertaken with commissioners if an in-patient bed was required although this was unusual for patients with eating disorders.

The CQC report had made a total of 137 recommendations covering NELFT as a whole and 106 of these had now been completed. A quality improvement had been introduced to encourage clinicians to make small changes in order to improve services.

Reports on safer staffing levels were compiled by the Trust on a monthly basis and all staffing trends were closely monitored. The Trust had now reduced its previous reliance on agency staff.

It was noted that the NELFT Quality Account had not been received by the boroughs.

The Joint Committee noted the position.