"Disappointed at closure of St Francis Hospital's Bestwood Ward "

Thank you for taking the time to post your concerns regarding your father’s care and the proposed closure of Daybrook and Bestwood wards.

Understandably your father’s care is a large concern to you I would advise you to discuss his discharge plans with a senior member of the ward team or with Sharon Howe, Matron (0115 8542257) to ensure he receives the right care for him both in hospital and after discharge.

You are correct in that the original intention was to look at closure of these wards in October. The rationale for potentially closing Bestwood ward earlier was due to having a large number of vacant beds across the dementia wards. In order to maintain patient safety and continuity of care we were planning to amalgamate the staff and patients on to other wards. However recently there has been an increase in admissions and so Bestwood ward will remain open until we have enhanced community based services.

The intention is to enhance community services by expanding Intensive Recovery Intervention Services (IRIS, which you refer to). The Intensive Recovery Intervention Services are provided by Mental Health Services for Older People for people who live in the county area and are made up of specialist nurses, occupational therapists, physiotherapists and support workers specifically trained to work with people with dementia and older people with other mental health conditions. They provide care for people in their own homes who are at risk of being admitted seven days a week, up to 4 times a day. The service has been very successful in supporting people with dementia and other mental illnesses who need extra support in being cared for at home, maintaining a familiar environment for the person with dementia. Part of the plan for reinvestment is to look at an equivalent service for city residents and an increase in the hours covered by state registered staff in the teams. Also there will be an enhancement of the current Dementia Outreach Services who support people in care homes with dementia.

Commissioners have agreed in principle to the closure of the two wards and informal meetings have been held with patients and carers on Daybrook and Bestwood wards. However formal consultation can only commence once the proposal has been approved by the Overview and Scrutiny Committee in the city an county local authorities.

The rationale for the closure of the two wards is based on the following:

• The independent review of the usage of older people’s beds showed that there were few alternatives to admission to hospital and that once people were admitted it took a long time to discharge them, again due to the lack of alternatives

• The benchmarking data shows that we have a larger number of beds than the national average

• National guidance that recommends increasing support for people in their own home, especially for older people and to provide earlier interventions

• Some cost savings – but community resources need to be invested in as an alternative

• Since the investment in Intensive Recovery Intervention Services there has been less demand on the beds from the areas with these services

• Patients and carers tell us that they would prefer to stay at home rather than come into hospital

• There is a very real need for MHSOP to deliver services to an increasingly ageing population with less monetary resources than we have previously had

Thank you for acknowledging the impact on staff regarding the proposed changes. We are trying to support them during this time of uncertainty and are using our human resource colleagues to assist us. The Directorate has an excellent history of finding new posts either within its own services or on individual requests in other Directorates. It is anticipated that posts will be identified for all staff who require them either from existing vacancies, newly created posts arising from the service change within the community or from other Directorates. We will be offering them a package of training and support to take on these or other roles. MHSOP staff are very experienced in the specialist care of older people and we want to continue using their expertise in the planned new community services.

Thank you for your response.

It is still planned for Bestwood ward to close in October.

If the patient numbers continue to reduce, for patient and staff wellbeing,safety and resource issues the ward may need to close earlier than planned.

Please be assured that patients will only be discharged if clinically appropriate.

Please feel free to contact myself or Sharon Howe Matron.

Thank you for your further posting.

I am sorry to hear you are having difficulties finding a suitable nursing home for your father. Please can we arrange to meet with you regarding your own personal situation with your father and his care? I am willing to meet with you, if you would like to give me a ring to make arrangements for this.

In terms of the ward closure proposals, they were discussed at the Local Authority Overview and Scrutiny Committee yesterday. From this six week patient engagement meetings will take place. We will send on the details of this once we receive them. This will be where more formal announcements will be made regarding the proposal and alternative community provision.

We acknowledge that proposed changes can make things very difficult and add a level of uncertainty. We appreciate the time you have taken in posting your comments and look forward to meeting with you to discuss them more fully.