Further improvements to mental health services in Lancashire have been agreed following a decision to conclude a long term programme of work.
Proposals were taken to CCG Governing Body meetings during July to agree a way forward and establish inpatient mental health services in Pennine Lancashire and Central Lancashire. Following an options appraisal that took into consideration previous consultation and engagement, it has been agreed that re-development work will take place at existing Trust sites to accommodate the services.
This will see the consolidation of beds at the Royal Blackburn Hospital site to provide a service for Pennine Lancashire and a service for Central Lancashire will be provided from Chorley Hospital.
The Pennine Lancashire inpatient service will be provided from the Royal Blackburn Hospital site. This follows enhancements to the existing service over the last few years and plans to consolidate all beds for the area there. More development work is planned at the existing Blackburn site to accommodate 12 assessment beds that will be transferred from the Burnley site to Hillview by September 2018. This is in line with previous consultation and engagement that was undertaken which identified the Royal Blackburn site as the preferred location for the Pennine Lancashire facility.
Land adjacent to the main Royal Blackburn site had been identified for a new development and the Trust had secured an option to purchase this land. However, due to the current economic climate, all NHS Trusts are now required to make the best use of resources and existing estate and other options had to be explored. Therefore the decision has been taken to make investments to improve the existing facilities at Blackburn and this will serve to enhance other developments that have been made there recently including improved accommodation for older adults and the provision of a crisis support unit.
On a broader locality basis, a facility will be opened in Burnley by the end of the year and delivered in partnership with the Richmond Fellowship to provide support to people who are experiencing a mental health crisis. It will provide short stay accommodation in a domestic setting with support from specially trained staff working alongside the Trust’s crisis services. An acute therapy service will also be provided in Pennine Lancashire, which is a psychological programme providing structured therapy in addition to practical, occupational, nursing and social support to people with low mood and who are deemed a risk of suicide and/or self-harm.
Extensive re-development work and expansion at Chorley Hospital will create an inpatient service providing 30 beds for adults aged 18 and over. Six psychiatric intensive care beds for women will also be provided from the facility which will become operational in 2018 following a major re-development. This will transform ward areas previously used by the Trust, providing private bedrooms and bathrooms, therapy spaces and access to garden areas.
A specialist service where new mothers who are experiencing mental illness can be cared for with their baby is also to be provided from the site. The perinatal unit will be one of only four new specialist services in the country and will provide 8 beds and a community service for women from across Lancashire and Cumbria. This will also become operational from 2018.
Investment has also been made into improving support for people who are experiencing mental health crisis. Willow House opened in Coppull in May 2017 to provide accommodation and support for people in a domestic environment with specially trained staff on hand, working in partnership with the Trust’s crisis teams. In addition to this, investment has been made to establish a Crisis Support Unit at Royal Preston Hospital that provides 6 spaces where people can be assessed and supported when they are in crisis. This service opened in July 2017.
Senior Responsible Officer for Mental Health, Lancashire and South Cumbria Transformation Partnership, Debbie Nixon, said: “The Lancashire Mental Health Acute Reconfiguration is near the end of a ten year process to improve mental health services and is part of the work across Lancashire and South Cumbria to improve health and care for local people.
“Meeting the mental-health needs of children, young people and adults is a key priority for organisations across Lancashire and south Cumbria and it is clear that we need to work together and in partnership to help people to access mental-health services quickly. In addition to making sure we have the facilities in the right place, we are working in partnership across Lancashire and South Cumbria to make sure there are enough well trained staff to support people, making sure mental-health conditions such as dementia are being diagnosed as early as possible and are improving the way we link physical-health needs with mental health needs.”
Chief Executive of Lancashire Care NHS Foundation Trust, Heather Tierney-Moore said: “Alongside my commissioner colleagues, I am pleased that we have agreed the next important steps to conclude a long term piece of work to improve mental health services across the county. This is about ensuring that people can access the support they need when they most need it. This will be made possible by ensuring that we have a range of services in place in the community that are able to offer support and keep people well and inpatient services in each locality that are of a good standard for those people who require an admission.”
“I am also really pleased that Lancashire Care is one of only 4 Trusts in the country to have been selected by NHS England to provide a specialist perinatal unit. This means that women from Lancashire and Cumbria will be able to receive this specialist care within the county instead of having to travel to Manchester or being separated from their baby. In addition to the unit, the service will also have a community element and this will ensure that new mums get the support that they need at this important time.”
Jan Ledward, Chief Officer of Chorley and South Ribble Clinical Commissioning Group (CCG) and Greater Preston CCG said: “Local people and our GP colleagues have long been telling us that they want to see improved mental health service provision in our area, so the decision to establish the inpatient unit, psychiatric intensive care beds and perinatal unit at Chorley Hospital is a really positive step forward. Improving mental health services continues to be a priority for our CCGs and we will carry on working closely with Lancashire Care to ensure patients receive the high quality, timely care and support they need both in hospital and in the community.”
Background to the Changes
A public consultation took place in 2006 and directed that more support should be available in the community for people with mental illness and that a better standard of facilities should be available for those that do need an admission, from specialist co-located sites across the county.
Since then, the Trust has established a range of community teams and two of the four planned specialist inpatient services, The Harbour in Blackpool and The Orchard in Lancaster are operational. The recent decision by commissioners was to determine the sites for the Pennine Lancashire and Central Lancashire localities and the wider support services within the community. This took into consideration the 2006 consultation and other recent factors including the Sustainability and Transformation Plan (STP) for Lancashire and South Cumbria and the implementation of the Five Year Forward View (FYFV) for mental health on a local scale. The STP and the implementation of the FYFV at a local level will result in further work and more developments in mental health services.
The Model of Care
Significant investment has been made into community services over the last 10 years so that the majority of people can be cared for outside of hospital when appropriate.
The Trust and commissioners have always been clear that the future model of care will be community based, supported with a pan-Lancashire network of beds. Inpatient services are important and necessary for those people who are not well enough to be supported in the community and it is important to highlight that this is a small minority of the whole population. The majority of people can be supported by community teams. The Trust has an extensive range of services to support people with mental health problems in the community.
Provision by Locality
- Existing community services; talking therapies (IAPT), community mental health teams, complex care and treatment teams, crisis and home treatment teams and A&E liaison services
- The Orchard, (18 beds for adults)
- The Cove, Children and Young People’s CAMHS Tier 4 service (18 beds)*
- Existing community services; talking therapies, community mental health teams, crisis and home treatment teams, complex care and treatment teams, restart and rehab teams and A&E liaison services
- Hillview/Pendleview, Blackburn: (79 beds for Pennine Lancashire.)
- Crisis Support Unit (6 places)
- A partnership with Richmond Fellowship will provide support to people in crisis from a domestic setting in Burnley
- Acute Therapy Service to support people in crisis
- Existing community services; talking therapies, community mental health teams, complex care and treatment teams, crisis and home treatment teams, restart and rehab teams and A&E liaison services
- Chorley Hospital, 30 beds plus 6 female PICU beds (psychiatric intensive care)
- Ormskirk Hospital (Scarisbrick Unit: 20 beds and 4 male PICU)
- Acute Therapy Service to support people in crisis
- Willow House, crisis support, Coppull
- Crisis Support Unit, 6 places at Royal Preston Hospital
- Specialist Perinatal (mother and baby) facility, 8 beds accessible to females from Lancashire and Cumbria*
- Guild Lodge, specialist low and medium secure inpatient service.*
- Existing community services; talking therapies, community mental health teams, complex care and treatment teams, crisis and home treatment teams and A&E liaison services
- Crisis Support Unit, location TBC
- Home View (12 bed step up/down facility)
- The Harbour (154 beds for adults and older adults including 30 dementia beds*)
*Highly Specialist Mental Health Provision
- The Cove, inpatient service for children and young people (Heysham)
- Guild Lodge, provide medium and low secure services (Preston)
- Specialist dementia beds (Blackpool)
- Perinatal (mother and baby) inpatient service (Chorley)
You can see a full and comprehensive list of all of the Trust’s services at https://directory.lancashirecare.nhs.uk/index.php