Minutes:
The Sub-Committee received a presentation from Adrian Dorney, Associate Director – Oxleas NHS Foundation Trust (“Associate Director”) regarding an update on Health Based Place of Safety (HBPoS).
Members were advised that a HBPoS, or s136 suite, was a safe place in which to assess people who had been detained in the community by the police under section 136 of the Mental Health Act. There had been two separate HBPoS sites within the Oxleas NHS Foundation Trust. One bed was based in Woolwich, at Oxleas House, Queen Elizabeth Hospital and the second bed was in the London Borough of Bromley, at Green Parks House.
Following a PAN London s136 review, in which a mapping exercise had been undertaken, it had been proposed that the current number of HBPoS sites in London be reduced. The HBPoS was part of a comprehensive Mental Health service, and whilst the benefits of scale and simplicity of access from reducing the number of sites were acknowledged, the Oxleas NHS Foundation Trust did not want to see a reduction in the number of beds within their footprint
It was highlighted that the refurbishment of the Oxleas House site would provide up to date facilities, and the best environment possible for this provision. In response to a question, the Associate Director said that this had included seeking guidance from psychiatrists, and visiting other provisions to see the high impact materials being used to keep patients safe.
From 1st January 2020, a Crisis Assessment Team (CAT) car had been initiated, serving Bexley, Bromley and Greenwich, which was a joint venture between Oxleas NHS Foundation Trust and the Metropolitan Police. It provided a nurse to travel with a rapid response team to s136, or potential s136, cases. The CAT car had been operating during twilight hours, which was when demand was at its highest. A London Ambulance Service (LAS) car, which provided a similar service, was also operating across areas of South East London covered by the Oxleas and South London and Maudsley (SLAM) NHS Foundation Trusts. Members requested that an update on the impact of the CAT car be provided to the Sub-Committee in six months’ time.
In response to a question, the Associate Director said that there were several factors which contributed to the peak time in out-of-hours demand. Local services had been developed, including a crisis service and Crisis Line which were both available 24 hours a day, seven days a week. It was hoped that as a result of more services being provided, fewer patients in crisis would present at Emergency Departments and support suites.
In January 2020, the s136 service had been reduced by one bed, following the closure of Oxleas House for refurbishment, throughout which the s136 suite at Green Parks House would remain functioning. At present, there had not been an adverse demand on impact at Green Parks House. The number of referrals showed that following the temporary closure of Oxleas House, there had not been a striking uplift in numbers attending Green Parks House. It was also highlighted that there had not been an adverse demand reported at the PRUH and QEH Accident and Emergency Departments, however this would be carefully monitored. The Associate Director noted that in relation to the impact of losing a s136 suite in Bromley, the Metropolitan Police had said that distance was not an issue, it was the ability to access it quickly and having two beds located on one site would reduce delays. The new two-bed s136 facility at Oxleas House was due to open in around twelve weeks’ time.
The Chairman led Members in thanking Adrian Dorney for his presentation, and noted that it was encouraging to see how the service was progressing.