BBC News: Norfolk and Suffolk mental health funding plan prompts dispute

Nic Rigby of the BBC reports:

Cash for future mental health provision in Norfolk and Suffolk has “fallen short” of what is needed, prompting a dispute with an NHS trust and a funder.

Norfolk and Suffolk Foundation Trust said funding offered by central Norfolk clinical commissioning groups (CCG) does not meet the “volume of demand”.

A trust board meeting was told the CCGs were “not commissioning sufficient capacity” in beds or staffing levels.

The central Norfolk CCGs said they were still in negotiations.

The meeting heard the plans put forward by central Norfolk CCGs did not provide enough funds for out of area placements, when no beds can be found in the area.

There were also issues surrounding staffing levels.

In previous years, the trust has been criticised over the need to send patients outside of Norfolk and Suffolk due to a shortage of mental health beds.

The BBC revealed that in November last year the cost of sending Norfolk and Suffolk mental patients to other parts of the country almost tripled to £600,000, from an average of £200,000 a month in December 2013 to September 2014.

In December, the trust said the number outside the counties had been cut to 24 from a high of 50 earlier in the year.

Non-executive director John Brierley said: “The issue is the commissioners are not commissioning sufficient capacity to the volume of demand.”

A Norfolk CCGs spokesman said: “CCGs across Norwich, South Norfolk and North Norfolk are still in discussions with the trust regarding the 15/16 contracting year.

“All parties are hopeful of a swift conclusion to current negotiations.”

In February, this year the trust became the first of its kind in England to be put in special measures due to it not providing a “safe service”.

So much for parity of esteem.

CCGs have been a disaster for mental health. We now learn from the latest NSFT Board papers that purpose-built adult acute beds are being closed at Carlton Court in October 2015 because Great Yarmouth & Waveney CCG thinks they are not needed for “local” people – where local means within its own arbitrary, bureaucratic boundaries. Meanwhile, Norfolk doesn’t have enough beds and the Norfolk CCGs refuse to fund them, at Carlton Court or elsewhere, resulting in people in crisis being transported across the country on the Map of Shame. The situation is becoming more shameful still: as the national shortage of beds worsens, up to a dozen older and half a dozen young people who should be receiving inpatient care have been left on the Waiting List of Shame hoping for a bed anywhere in the country.

The NSFT Board is now trying to present itself as “victim” rather than “villain” but the truth is Maggie Wheeler & Co. promised “enhanced” services with the radical redesign, happily accepted completely unrealistic funding and dismissed repeated warnings about plans for simultaneous cuts to community and inpatient services as “shroud waving“. The catastrophic result has been an Inadequate rating from the CQC and Monitor placing the trust into Special Measures.

Norfolk and Suffolk’s CCGs need to work together rather than argue about their own meaningless boundaries whilst paying themselves a fortune and ignoring public opinion. We need an integrated mental health service that delivers decent services across Norfolk & Suffolk. The public has repeatedly been promised that no beds would close while they are needed: well, Thurne ward at Hellesdon Hospital is fully reopened with 12 beds, yet the number of people out of area rose to 28. Carlton Court cannot be closed while its beds are needed. The lack of beds for local people was one of the main criticisms of the CQC inspection team. Remember that the CCGs and NSFT promised that there would be no use of out of area beds after April 2014.

Where will the people using Carlton Court go? NSFT’s own figures show bed occupancy running at over 100% and that the average cost of sending a patient out of area is £552 per person per night. Keeping an additional fifteen people many miles away from their family will cost more than £3 million per year in addition to the human misery. The “saving” from closing Carlton Court is listed in the latest NSFT Board papers as £450,000. Can any of these bureaucrats use a calculator? They seem to believe they are playing Age of Empires rather than working in the NHS: real lives are at stake.

Click on the image below to read the full story on the BBC News website: