Simon Ringland: Bringing patients closer to home is aiding in recovery

By Simon Ringland simonringland

It is well reported in the media that finding hospital beds for adults with severe mental health problems is increasingly difficult. Using out of area beds for treating mental health patients is now unfortunately common place and a national shortage in hospital beds is limiting choice, meaning some people having to travel long distances to access appropriate care.

Lincolnshire is not unusual, this is a national problem, made worse by an ever increasing demand on mental health services as people’s lives become more complex and more and more people are finding that they need support with their mental wellbeing.

It is great that at a national level there is a commitment to provide care as locally as possible, and stop people having to travel long distances to receive care by 2021. We are fortunate that our commissioners in Lincolnshire support this ambition and we’ve been working with them for several years to look at ways we can care for patients closer to home, in the least restrictive environment. In Lincolnshire this is very much the focus of improvements in mental health care, and a key feature in the county’s future health care plans.

A lot of work has already been done to improve admission and discharge processes locally, to ensure the beds we have are used as effectively and efficiently as possible. Our wards have been able to help people to be discharged home quicker and the time spent in hospital is around the national average, if not lower in some circumstances.

We have also been really pleased to be able to open the county’s first psychiatric intensive care unit (PICU). This 10 bedded male unit which opened last month has already helped make massive strides in reducing the number of people that have to go to a hospital elsewhere. This type of unit wasn’t something we’d been able to provide until now and meant that we only had the option of sending someone elsewhere in the country if they had challenging and complex needs.

The Hartsholme Centre, based on St George’s in Lincoln has enabled the team and I to bring all of the men receiving psychiatric intensive care back to Lincolnshire, and will mean that going forward that others needing this intensive level of support have somewhere locally that can support them.

We currently have six men on the unit who have settled in really well and are pleased to be back closer to their friends and family.

The unit has been refurbished to a really high standard and is providing state of the art features which will no doubt aid in recovery.

The whole environment has been designed to be as safe, but homely as possible. It is great for our team as we are able to attend meetings regularly with the professionals to plan for discharge really early in someone’s recovery and stay in touch with changes in their needs.

We are hoping that everyone will be able to be discharged home quicker as a consequence of the team being able to respond quickly to the people’s needs and being able to ensure that appropriate community care is in place when they can go home.

This is a key role for my team and we work with commissioners and services both in Lincolnshire and nationally, to not only help find the most appropriate place for someone who is very unwell and needs hospital care but also make sure that they can be discharged home quickly, especially when they need to receive care in a facility outside of Lincolnshire. We keep in contact with the unit, to make sure that when they are ready to be discharged we can make sure that they have appropriate support in place to come back to.

Commissioners and local services are acutely aware that it is always better for that person to stay as close to home as possible. We know that being away from family and friends, as well as the professionals that people are used to receiving support from, can have a detrimental effect on their recovery and can sometimes mean their stay in hospital can take longer. So we always work with commissioners, local services and other providers to find somewhere that is as close to home as possible, but at the same time will get the right help they desperately need.

The new PICU is a positive step forward for local services and we are continuing to work closely with commissioners on other developments that could help us care for even more patients closer to home. This includes looking at providing an equivalent service for females and expanding the community crisis and home treatment services available to prevent people needing to go into hospital in the first place.

It’s great to see that the Hartsholme Centre is already having a positive impact and is offering faster and more appropriate support for people in their time of need.

Simon Ringland is bed manager for the adult inpatient mental health division at Lincolnshire Partnership NHS Foundation Trust.