NHS and Social Services pleased with Older People's Services Feedback

06/10/2004

The NHS and Social Services in Gloucestershire say they are encouraged with the quality and quantity of consultation feedback, which will help shape the future of Older People's Mental Health Services.

Over 150 replies were received from service users and carers in response to the 'Everybody's Business' consultation which looked at a number of important areas such as support for carers, staff training at all levels, development of extra services in the community, day care, inpatient hospital services and long term living (e.g. extra care housing, care homes).

In addition, a number of events were held across the county to receive feedback on how service users and carers view current services and how they would like to see services develop in the future.

In terms of inpatient services, there was overwhelming acknowledgement that more needs to be done to avoid some admissions to hospital beds.

The vast majority of respondents said that expanded community services (e.g. more flexible breaks for carers, development of community mental health teams, more home care and more extra sheltered care housing) should be available for people who are not seriously unwell.

In addition, 93% of respondents said that fewer hospital beds would be needed if these expanded community services were in place.

Older People's Manager at West Gloucestershire PCT, Helen Bown said:

"In work with service users and carers, the message comes through time and time again that people want to receive the necessary help and support to enable them to stay at home for as long as possible."

"We will always need in-patient facilities and beds, but service users and carers have told us that we may not need as many as we currently have. We need to think about how we can develop community mental health services closer to home so that service users do not reach the stage where a prolonged stay in hospital is necessary."

The consultation showed that there was also substantial support for increasing the availability of short-term support to service users when they leave hospital. This kind of support provided by highly trained community based staff (and known as 'Intermediate Care') can help people to regain their independence more quickly.

Most respondents to the consultation (91%) believe that care services (Social Services, housing agencies and health services) should work to help maximise the independence of service users even if they are no longer able to remain in their own home. Extra care housing should be expanded to support people to live as independent life as possible in their community.

County Councillor Mark Hendry, Portfolio Holder for adult care said:

"Extra care housing projects are now demonstrating successfully that people with mental health needs who would otherwise have been admitted to hospital can live more independent lives."

"The advantage of this approach includes the possibility of couples continuing to live together where they may otherwise face separation."

However, the consultation document explains that the majority of older people with mental health needs are cared for in their own homes and there was also support for an increase in community based services to reflect this.

95% of people said that *community mental health teams should be expanded to support service users and carers to provide care to service users at home, or as near to home as possible.

The need for fully trained staff working at all levels in health and social services who understand the needs of older people with mental health needs was also seen as important.

97% of respondents said that trained staff in GP surgeries should play an increased role in assessment and earlier diagnosis of mental illness and 97% believed that links between Social Services and GP surgeries should be strengthened to improve support.

Consultant Psychiatrist for Older People's Services at Gloucestershire Partnership NHS Trust, Dr Nick Ardagh-Walter said:

"With an ageing population, prevention is becoming more and more important. By strengthening community mental health teams and the training that is available to health care workers including staff who work in GP surgeries, many believe we would see earlier diagnosis, quicker access to appropriate drug treatments and closer monitoring of how an individuals disease is progressing. All this could help to reduce unnecessary hospital admissions and crisis situations arising."

Most service users and carers believe day services should be made available closer to the service users' home. According to respondents, locally based assessment and therapeutic clinics should be developed as a way of providing specialist day support and increasing links to GP surgeries and other community mental health services.

In the section requesting feedback on supporting unpaid carers, the majority of respondents (62%) said that there should be more opportunities for short flexible breaks (either at home or away from home) and 30% of respondents said that there should be more information about services and support groups.

Helen Bown again:

"These important issues identified by service users, carers and by health and social services staff challenge the way we currently provide services. Current service provision relies too heavily on beds in hospitals in the county at the expense of supporting people in the community or at home."

"At the moment, there are 122 beds designated for older people with mental health needs. On an average day, 36 beds are not used and 24 beds are only being used because the right services are not available in the community. This means that on an average day only half of the beds are being used by older people who need specialist mental health care in a hospital bed."

"We (NHS and Social Services) will need to look carefully at how we can redistribute some of our resources to expand community based services before we make recommendations on hospital beds."

"We will now continue our review of services and make recommendations based on what our service users and carers have told us."

Stage Two of the consultation will be launched early in the New Year, with specific recommendations for services based on the views of service users and carers.