Agenda item

Avon and Wiltshire Mental Health Partnership NHS Trust (AWP) was asked to make significant improvements to the provision of Health Based Places of Safety (HBPoS) at Sandalwood Court in Swindon and Fountain Way in Salisbury following two Care Quality Commission (CQC) inspections in 2016 and 2017, which rated these services as inadequate.

The attached report appraises the options for future service provision and was presented to the Swindon and Wiltshire CCG Governing Bodies in September 2019 for ratification and approval.

The recommendation from both Governing Bodies are being presented to Swindon Adults’ Health, Adults’ Care and Housing Committee and Wiltshire Health Select Committee.

The Committee received an Options Appraisal Report on the temporary closures of health based places of safety in Swindon and Salisbury from Sheila Baxter, Mental Health Commissioner and Ruth Atkins, Head of Communications & Engagement, Swindon CCG. 

Members were informed that Avon & Wiltshire Mental Health Partnership NHS Trust (AWP) had been asked to make significant improvements to the provision of Health Based Places of Safety (HBPoS) at Sandalwood Court in Swindon and Fountain Way in Salisbury following two Care Quality Commission (CQC) inspections in 2016 and 2017, which rated these services as inadequate.

The report appraised the options for future service provision and had been presented to the Swindon & Wiltshire CCG governing bodies in September 2019 for ratification and approval.

The options considered for the appraisal were:-

Option A – To make permanent the Bluebell Unit arrangements based in Devizes, with no health based places of safety at Sandalwood Court, Swindon and Fountain Way, Salisbury.  This would provide four HBPoS beds for the Sustainability and transformation Partnership (STP) area and this was enough based on data.

Option B – To maintain the Bluebell Unit in Devizes as a dedicated unit but to re-open the place of safety suites at Sandalwood Court and Fountain Way.  This would provide six beds for the Sustainability and Transformation Partnership (STP) area and this was above requirements based on data.

Option C – To roll out the additional Bluebell Unit clinical model in Swindon and Salisbury. This would provide 12 beds for the Sustainability and Transformation Partnership (STP) area and is above requirements based on data.

It was noted that a clinical led panel consisting of a GP from Swindon, a GP from Wiltshire and the secondary care doctor on Swindon CCG’s Governing Body had considered each option against the criteria. The panel had expressed some concern relating to the ability to staff three units, value for money, estate costs and travel. In addition to the clinical panel, the managers of Healthcare Swindon also carried out the scoring, considering each option against the following criteria:-

·         Quality

·         Environment for staff and detainees

·         Workforce sustainability

·         Travel distances

·         Cost effectiveness

The recommendation from both of these governing bodies was to support and endorse Option A, namely to retain a health-based place of safety at the Bluebell Unit in Devizes, with the closure of the health-based place of safety suites at Sandalwood Court, Swindon and Fountain Way, Salisbury.

The recommendations from both governing bodies were being presented to Swindon Adults’ Health, Adults’ Care & Housing Committee and this Select Committee.

During discussion, Members questioned the view that four HBPoS beds would be sufficient for the needs of Wiltshire residents and were reassured that should the need arise, Bristol residents would be catered for outside of Wiltshire.

The Committee recognised the financial and practical reality of the option chosen by the Swindon and Wiltshire CCG Governing Bodies, namely to retain a dedicated health-based place of safety (Bluebell Unit) in Devizes, with the closure of the health-based place of safety suites at Sandalwood Court (Swindon) and Fountain Way (Salisbury) based on the assurance that the number of beds available will remain under constant review to ensure it meets local demand (with an update in 6 months); however remains concerned over issues of capacity and charging other local authorities to cover costs when they use the Bluebell Unit.

Resolved:

(1)          To receive confirmation of the agreement reached with regards to charging other local authorities for the use of the Bluebell Unit, including the out of hours AMHP provision, when available.

(2)          To receive confirmation of an agreement reached with BANESSG regarding the use of the Bluebell Unit to protect capacity for the use of local people, when available.