Agenda item

The chair invited Lambeth and Southwark teams to present.

David Bradley, Chief Executive, South London and Maudsley NHS Foundation Trust (SLaM) introduced the presentation by saying the committee’s 15 recommendations had all been accepted.

Nancy Kuchemann, Southwark GP, and mental health lead for South East London (SEL) Clinical Commissioning Group (CCG) thanked the committee for a compelling and detailed case. The recommendations were strongly supported at SEL CCG.

It was reported that work has now started on site and the Douglas Bennett House at the Maudsley Hospital is being redeveloped to provide eight purpose-designed, modern adult inpatient wards.

Dr Robert Harland, Clinical Director for Lambeth Adult Services at SLaM, emphasised the improvement to the new provision and in particular the provision of on- suite bathrooms. The integration of physical and mental health is also of benefit and been vital with COVID-19.

A service user described the current provision being replaced as having long dark corridors with nursing stations far away, poor bathrooms and no green spaces or places to relax.

Natalie Creary, Programme Delivery Director, Black Thrive, reported on the work developing a culturally appropriate inpatient process. A service user gave an insight on the co - design process with service users, remarking that she has thoroughly enjoyed working with Black Thrive and their voices had been registered. Interviews had taken place with service users and they had also been involved with devising job descriptions, which she reported had been very valuable.

Neil Jackson, Director of Capital Planning, Estates and Facilities, SLaM, went through the future plans for the Lambeth Hospital site, covering the master plan and provision of affordable housing, in particular.

Carla Fourier, Director of Social Care, SLaM, covered the aftercare arrangements with council partners, particularly Lambeth and Southwark, but also other boroughs. A draft memorandum of understanding was presented around Section 117 in November to council leads. She explained that this is a complex legal situation, as frequently service user’s move between boroughs.  Further work is ongoing on this.

Jo Kent, Deputy Director of Southwark Adult Mental Health Services, SLaM explained that SLaM uses limited private provision. Work has been done looking at future projections on service use for Southwark residents, which demonstrates that there is local bed capacity until 2027, but action will need to be taken to plan beyond this date.  Nancy Kuchemann spoke about Southwark services users, the potential impact on local services, and summarised by saying she was satisfied Southwark is in a good place there.

David Bradley said that the impact of COVID -19 has slowed work but it is still on track.

The chair then invited questions and the following points were made:

• The risk of the pandemic adding costs to the building has been mitigated and controlled through the use of two separate teams on shifts to enable work to continue if, and when, there are outbreaks. A similar methodology has been applied to the supply-chain.

• The contract for construction is based on a guaranteed maximum price in order to transfer as much risk as possible to the supplier. Some risks, for example COVID-19, do sit with SLaM. There is also some contingency in the price that gives comfort.

• There is ongoing work to provide direct access from the train station and improve open space.

• There are plans to provide a safe space crisis cafe as an alternative to A & E and Place of Safety. Sometimes people need both.

• The disposal of the Lambeth Hospital will be utilising a commercial approach to maximise value for the public purse, with engagement with the market in the summer, once the money is in place for development.

• The sale of the Lambeth Hospital site has been agreed with the Regulator, with provision for a bridging loan in order to provide flexibility with the market.

• A special purchase vehicle is being considered for the Lambeth Hospital redevelopment, however this is early days. Partnerships are the only way forward as there is a large financial risk, which is contained in a special purchase vehicle. Regulatory approval is being sought for this in order to bring maximum value to the public purse. It would be entirely transparent.

• The Douglas Bennett provision is aimed at adults 18-65. In addition to this Kings Health Partners are building a new international children’s site for mental health, although this is not being directly covered by the committee. .

• All clinical and non clinical services at the Lambeth Hospital will continue, either in the community or as inpatient services at the Maudsley.  Work is ongoing to establish where to locate in the community, and assurances were given that none will be down graded and all will rehomed.

• Patients would be admitted based on an assessment of needs, and to not admit would be very exceptional. Assessment is based on needs, not on the resident borough  even though commissioning is planned around boroughs.  There is confidence there will be enough beds for people in Southwark.

• Black Thrive work on ensuring culturally appropriate impatient care was welcomed. Black Thrive said that although COVID -19 has been a challenge in doing outreach, everything is on track although things could change and they may need to flex. Black Thrive is recruiting more team members as it becomes an independent entity spinning out from Healthwatch Lambeth .This extra capacity will help.

The Chair and members thanked Lambeth and Southwark teams for providing comprehensive updates on the recommendations, and how these have been already implemented or are on track. The service user input was identified as of particular value as well as feedback from  Black Thrive on the strength of engagement.

RESOLVED

The chair summed up by saying that informal lines of communication would  remain open until at least the opening the Douglas Bennett House, expected to open in early 2023,  with the option of reconvening formally if necessary.

The following briefings were requested:

• Update on Transport initiatives, particularly on the Streatham and South Norward areas and how these will materialise and enable the new site to be accessible for communities from these localities,

• More clarity on  the A & E emergency entrance and that this is fit for purpose,

• The process of engagement in Southwark,

• Update on Black Thrives co-design process with service users and the  Living Well Centre.