Here is our response to Andy Evans, Chief Executive of Great Yarmouth & Waveney CCG (HealthEast), following the disastrous decision to close beds at Carlton Court:
Mr Andy Evans
Great Yarmouth & Waveney Clinical Commissioning Group
1 Common Lane North
1 October 2014
Dear Mr. Evans,
Following your disastrous decision to lose 22 inpatient places in Gt Yarmouth and Waveney on 25/9/2014, one of our members (Terry Skyrme) was on AMHP duty the following day. There were a number of referrals for urgent assessments, but two of them highlight the big mistake you are making regarding dementia services. The DIST made referrals for two patients both living in residential care who needed urgent admission to a dementia assessment unit. THERE WERE NO BEDS AVAILABLE IN THE WHOLE OF NORFOLK AND SUFFOLK. We stress that this is the norm not the exception, and again we have to say that all the CCGs are breaching their duty under Section 140 1983 Mental Health Act, which is to ensure that beds are available for urgent admissions. Both patients were eventually admitted. One was admitted to Blickling Ward but only after a senior manager instructed the staff to move a patient from Blickling Ward to one of the long-stay wards in Hammerton Court to create a vacancy, obviously a decision made not on clinical grounds but on financial expediency. As it happened the patient who was asked to move late in the evening without warning refused to do so and locked herself in her room. When the new patient arrived it meant that the ward had two patients over their full capacity, and the nurse in charge had to ring round other wards to see if they could spare some staff; they couldn’t (By the way, the ratio of agency staff for that day’s 3 shifts was 13 agency to 10 substantive staff). The other urgent admission was admitted to Sandringham ward which as you know is not a dementia assessment unit.
As a Campaign we are fully aware of the financial cutbacks imposed by central government and the pressures you and the Trust are under. Where we take issue with you is when you claim that your strategy is based on a best practice model. How can there be best practice when dementia wards are constantly over 100% occupied with massive pressure to discharge people or not to admit people not based on clinical need but on expediency? How can there be best practice when over half staff numbers are agency staff? We have spoken to Central Norfolk DIST who have in the past operated on a 24 hour basis. They say that this will make little difference to the quality of care provided as the demand does not come in the middle of the night. Extending DIST to 24 hours sounds good but will make no impact on the demand for inpatient beds.
In our view there seems to be a complete lack of a coordinated strategy for inpatient services within the Trust and between CCGs in Norfolk and Suffolk. We now hear rumours that the Psychiatric Intensive Care Unit at Rollesby Ward at Hellesdon Hospital will close and that the only PICU in Norfolk and Suffolk will be the one based at Lark Ward, Ipswich. Can this be true? Have you been consulted on this? Will there be a public consultation? We estimate that over 120 inpatient places have been lost in Norfolk and Suffolk due to the Radical Redesign. When will this piecemeal cutting of services stop and a proper strategy based on need be presented to the public?
You may dismiss the above account as anecdotal but it is a true reflection of the state of affairs on the ground. We have applauded you for consulting the public but you have now chosen to ignore the results, thus increasing the cynicism of the people you should most seek to involve.
Terry Skyrme on behalf of
The Campaign to Save Mental Health Services in Norfolk & Suffolk