Developing mental health services in the Western Isles

Following an extensive Option Appraisal process with members of the public and staff to consider how best to modernise mental health services in the Western Isles, Western Isles Health Board this week (Thursday) agreed on a preferred model of service, to be fully developed into a detailed proposal.

Option Appraisal meetings took place in Lewis, Uist and Barra in January 2012, when members of the public, staff and other partners met to consider and ‘score’ three options to modernise mental health services. The highest scoring preferred option for the majority was Option 3, which would create an increase in community capacity by reducing inpatient facilities. This could be done in a number of ways, including changing the current two inpatient facilities (Acute Psychiatric Unit and Clisham Ward in Western Isles Hospital) to a single unit with a reduced number of beds (around eight to 10), for both adult and old age psychiatry.

The case for change is based on an understanding that the way services are currently configured in the Western Isles does not allow for an effective, locally delivered approach to mental health service provision. Modern community based services consist of teams of practitioners, including specialist nurses and doctors and support workers, who often work closely with local authority and third sector colleagues to deliver effective integrated locally based services. In our current model, such teams cannot be developed while capacity and manpower is centred in Western Isles Hospital.

Accepting that the current service model falls some way short of delivering a modern approach to mental health service provision and the NHSHealthcare Quality Ambitions, work therefore progressed to develop alternative options to enable ongoing modernisation and further shift the balance of care closer to home.

At Thursday’s Board meeting, Dr James Ward, Medical Director for NHS Western Isles, stressed that, during public engagement and Option Appraisal meetings, the need for local access; namely access to services closer to home was a key priority for all who attended. Option 3 would successfully deliver this objective, and Board members agreed on this option as the preferred ‘direction of travel’.

Dr Ward added that, by agreeing on a preferred option for mental health services, the Board could then progress to a detailed three-month consultation process with members of the public, staff, third sector partners, and other stakeholders. More detail around the preferred option would then be developed, within the existing financial envelope for mental health services.

“Option 3 is an integrated and pragmatic approach to service modernisation,” said Dr Ward. “Our aim is that high quality engagement and consultation with the public will take place over three months from August to October 2012, when we can discuss the detail of acute service configuration, community service modelling and partnership. The consultation process will also allow for any specific concerns to be considered and discussed in detail.”

Following the consultation process, detailed service, workforce and financial planning will be progressed and a further paper will be presented to the Board for approval.

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