Developing a new vision - NHS Newcastle Gateshead CCG · 2016-07-12 · Developing a new vision for...

NHS Gateshead Clinical Commissioning GroupNHS Newcastle North and East Clinical Commissioning GroupNHS Newcastle West Clinical Commissioning Group

Newcastle Gateshead Alliance

Developing a new visionfor mental health services for Gateshead and Newcastle

Listening to and collecting your views and experiences about specialist mental health services

November 2014 to February 2015

Transforming lives together Transforming lives together Transforming lives together Transforming lives together

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Who are we?We are the Newcastle Gateshead Alliance which is a partnership of NHS Gateshead Clinical Commissioning Group, NHS Newcastle North and East Clinical Commissioning Group and NHS Newcastle West Clinical Commissioning Group.

While we are individual clinical commissioning groups (CCGs) for our own areas, we also work together on common healthcare issues in order to improve the health and wellbeing of people living in Gateshead and Newcastle.

What are clinical commissioning groups?

Clinical commissioning groups (CCG) are made up of doctors, nurses and other health professionals, supported by experienced health service managers.

‘Commissioning’ is the planning, choosing and buying of local health services to meet the needs of local people.

All local GP practices are members of the CCG and work alongside specialist healthcare professionals, combining expertise and experience to improve healthcare services and benefit the people of Gateshead and Newcastle.

What does this mean for patients?

Because the CCG is made up from GP practices and family doctors we believe we are well placed to fully understand our patients’ needs, and are able to develop responsive health services, making sure that patient care is always at the heart of our decision-making, and ensuring we continue to provide best practice and evidence-based medicine.

You can find out more about Newcastle Gateshead Alliance at:

www.newcastlegatesheadccgalliance.nhs.uk

Developing a new vision for mental health services for Gateshead and Newcastle

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Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Setting the scene . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Key facts and figures . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Why things need to change . . . . . . . . . . . . . . . . . . . . . . . 12

Improving specialist community mental health services (services outside of hospital) . . . . . . . . . . . 16

Potentially relocating the current adult in-patient units . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

Ensuring a place of safety - section 136 suites . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

Services for people with especially complex mental health needs. . . . . . . . . . . . . . . . . . . . . . 32

Services for older people (Newcastle only) . . . . . . . . . . . . 38

Transport and travel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

What do we need to know from you? . . . . . . . . . . . . . . . 42

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IntroductionThank you for taking the time to read this document.

If you live in Gateshead or Newcastle and have experience of, or an interest in, specialist mental health services – we would like to hear from you.

The sorts of services we mean are those you might get from a community psychiatric nurse (CPN) treating you at home, through to the more serious but thankfully much rarer cases when people might need to spend time in hospital.

It’s really important to remember that we are not talking about the sort of mental health problems for which you get care from your GP or primary care counsellor or therapist. These are more common mental health issues, such as anxiety or depression, and they are well treated by your GP with talking therapies and sometimes medication.

The specialist services that we are talking about in this document are the much more complex mental health issues like severe depression, schizophrenia, psychosis and personality disorders.

We would like to know what you think of the services, your experiences and your views on those which need to improve. We are very much open to listening to ideas for improvements, and how we might be able to do things differently in the future.

We have included some questions in each section. There are several ways you can get involved to give your views which are listed at the back of the document on page 42.

Your experience may be as a service user, or as a carer to someone who has used services. You may be a member of the public with an interest in mental health, or from an organisation that provides services that supports people with the sorts of conditions we talk about in this document.

We are interested in a whole range of views. We want as many people as possible to get involved in giving their opinions. This will help us decide together how we can arrange mental health services in a better, more effective way and we can help more people recover sooner.

Why is this important?

Mental health services have changed dramatically over the last 30 years and those changes need to continue. This is so that we can keep improving the quality of services, support people to have a better quality of life, recover sooner and challenge the stigma of mental health which still exists in society.

In Gateshead and Newcastle we want to provide the best local services, as early and as close to home as possible.

Given the growing demand for services, NHS England predicts a national funding shortfall into the NHS of nearly £30 billion a year if no further efficiencies in the services are made, and funding is not secure at current levels.

Mental health services have changed dramatically over the last 30 years and those changes need to continue.


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Most people with a mental health problem are treated by their GP and supported to remain at home, and they will possibly get help from a community mental health team, a psychiatrist or another specialist worker.

Only a very small number of people will ever need to be treated in hospital. We want to make sure that specialist community services support people very well, and early on in their care, so that people don’t get worse and don’t need to be admitted to hospital.

We want to make sure that all our services are focused on helping people to recover sooner, and get back to having the best opportunities and life they can.

We also want to make sure that hospital based services are able to support people with very complex needs in a safe and person centred way.

That’s why your views are so important – we want to decide together about the best way to meet local needs, most effectively, within the budget we have. We know that currently services do not always meet people’s needs and local people spend longer in hospital than those in other parts of the country. These are all things which we want to change.

All of these services need to be financially sustainable.

Together with local partners which include Newcastle City Council, Gateshead Council, Northumberland, Tyne and Wear NHS Foundation Trust (known as NTW), and representatives of users, carers and the voluntary and community sector, we have been looking carefully at the services for people with serious mental health conditions.

For this document we have focused on those health services provided by NTW Foundation Trust. However we recognise that people with serious mental illness will use a range of services provided by other health trusts, local authorities and the voluntary sector. You are welcome to share your views and ideas about the whole range of services and support as part of this process.

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We would like to talk about the difficult and challenging issues which face mental health services locally and across the country. We have some difficult decisions to make, and we would like you to influence and shape those decisions.

What we are trying to achieve

We want an open and honest conversation between the local NHS, partners and local people.

In the NHS, we often call this a consultation, however, this is different from those that you might have been involved in before. No decisions have been made and we’re asking a series of questions which we would like to explore.

Often the NHS is criticised for agreeing one option and then going out to consult with the public, with people sometimes feeling that a decision has already been made. At this stage there are no options.

During the summer and autumn 2014, we held a number of early meetings with people from Gateshead and Newcastle who have an interest in these services.

We have published a report into these events which identified the key issues and themes that are important to local people – you can find this on our website.

We are asking a series of questions which we would like to explore. Through these questions, we would like understand what is important and reach an agreement about future services.

This document aims to explain the real challenges that we face in providing specialist mental health services in Gateshead and Newcastle.

We are honest about the rising demand for care, changing expectations from service users, some of the poor hospital buildings and environments, and the reality of less money to spend on mental health services.

This means that we need to act and make big changes to how we do things, so that we protect and improve future services.

Despite this difficult situation, it does give us a real opportunity to improve specialist mental health services in Gateshead and Newcastle.


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We will ask you how you think we can do things differently, how we can make services easier to find out about and access, how we can become more focused on getting involved much earlier with patients, and help them recover sooner.

We will also ask how we should prioritise and spend the money we have for mental health care and services.

It is very important to remember that no decisions have been made by the clinical commissioning groups to implement any major changes.

What we find out from you during these winter months of intensive listening will be used by all the organisations involved to develop options or scenarios for changes which will be subject to a formal consultation period later in 2015.

We know that hearing about change can be worrying, but we hope that you will take the time to understand the complex issues that are involved in this debate, ask us questions, feedback your views and get involved in helping us to find the answers.

We really want to work with you, our services users, carers and stakeholders to share and understand the challenges we face for mental health care. Together develop solutions to those challenges.

We know this is a long document with lots of information, but we have tried to structure it in a way where you can go to the area of care that might interest you the most.

My clinical colleagues and I look forward to having these discussions over the next few months. We know that by working together, and understanding the challenges and issues we have for the local NHS, we can develop and commission the best possible care and secure the future of mental health services for the people of Gateshead and Newcastle.

Dr Guy Pilkington

GP chair of NHS Newcastle West Clinical Commissioning Group (on behalf of NHS Newcastle Gateshead Alliance)

Chair of the Gateshead and Newcastle Mental Health Programme Board and Newcastle GP

“My clinical colleagues and I look forward to having these discussions over the next few months.”

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Our priorities for improving healthcare in Gateshead and Newcastle

As the group of clinicians responsible for leading local healthcare, we feel that it’s important that issues contained within this document are seen in the context of our vision for how we plan to improve healthcare and health services for local people.

The objective for patient care set by the Government is that there will be “no decision about me, without me”.

We believe that this should be carried through all aspects of healthcare, determining how we plan and commission our healthcare and health services. We are conscious to always involve our patients in care and in health service decisions which is why we are taking the approaches set out in this document.

As well as involving patients, and the local community and voluntary sector, we also work very closely with the two local councils.

Along with NTW, we are also members of the Health and Wellbeing Boards in both Gateshead and Newcastle.

The mental health programme board

The mental health programme board oversees the development and implementation of mental health strategy with the purpose of improving the emotional wellbeing and mental health of the people in Gateshead and Newcastle.

The board seeks to make improvements through developing and better co-ordinating the commissioning and delivery of all services, from preventative through to highly specialist services.

The membership of the board includes the clinical commissioning groups, Newcastle and Gateshead local authorities, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne Hospitals NHS Foundation Trust, South Tyneside NHS Foundation Trust and Gateshead NHS Foundation Trust.

There are also key groups representing service users and carers, such as voluntary sector advisory group (mental health) known as VOLSAG, Launchpad, Advocacy Centre North, Gateshead Mental Health User Voice, Gateshead Crossroads and Newcastle Carers Centre.

The programme board has agreed a set of principles for all improvement work and are shown in the box opposite.

Setting the scene


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How to use this document

The term ‘mental health services’, covers a huge range of different areas of support, and it can be easy to be confused by the different types of care.

To make this document as easy to understand as possible, we have split it into a number of different topics, these topics are:

• Improving specialist community mental health services (services outside of hospital)

• Potentially relocating the current adult in-patient units in Gateshead and Newcastle, and reducing bed numbers overall

• Ensuring a place of safety – section 136 suites

• Services for people with especially complex mental health needs

• Services for older people (Newcastle only)

• Transport and travel

Principles of the mental health programme board:

• Being bold, brave and creative

• Ensuring service users see the right person, at the right time, and the right place

• Improving service quality and patient experience, safety and effectiveness

Each topic will include important information, and will highlight the areas we would like your views on.

As part of this listening process we will hold a special event called ‘how we can spend the Gateshead and Newcastle mental health pound’.

This is when people can find out about the money that is available for mental health care and services and give their views on how they think it should be spent.

If you are interested in taking part in this please see more information at the back of this document on page 42.

If you are only interested in a specific aspect of care or services, you should be able to turn straight to that section to find the relevant information.

To make it as easy as possible to give your views we have developed a questionnaire to sit alongside this document.

Full information about the different ways you can get involved and give your views is included at the back.

• Ensuring carer and user focused outcomes

• Ensuring there is engagement and involvement

• Recognising diversity and the need to ensure equality

• Hope, meaningful choice and control, and recovery orientated

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Key

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Community-based care

Inpatient services

1171 in Gateshead CMHT

1161 in Newcastle North East CMHT

1152 in Newcastle West CMHT

822 in Newcastle Older peoples CMHTs

234 people in Gateshead memory protection services

564 in Newcastle memory services

CMHT: Community Mental Health TeamNTW: Northumberland, Tyne and Wear NHS Foundation Trust

62%66 of 105 Newcastle patients were in service in Newcastle

71%27 of 38 Gateshead patients were in service in Gateshead

Inpatient: 143/6352 (2.2%)

Community: 6209/6352 (97.8%)

6352

143people using inpatient services from NTW

72%

This included:

Split:

On an average day 1st October 2014

6209people open to community-based care from NTW

There were

people open to NTW services in Gateshead and Newcastle

There were

of people were from Newcastle (4491 of 6209)

28%of people were from Gateshead (1718 of 6209)

There were


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Location for inpatient admission/transfer 2013/2014

Total numbers of individual people using inpatient services over 2013/2014

Northumberland St George’s Park 744 17

30416 89NewcastleHadrian Clinic

541GatesheadTranwell Unit

602 20

Older peopleStepped care rehabilitation Adult admissions/transfers

South Tyneside/SunderlandBede Wing/Cherry Knowle Hospital

NorthumberlandSt George’s Park 112

131NewcastleHadrian Clinic

23619GatesheadTranwell Unit

1158South Tyneside/SunderlandBede Wing/Cherry Knowle Hospital

From Newcastle West and East CCGs

From Gateshead CCG

Please note these admission figures track a servce users journey through the pathway. Each service user may make a number of admissions and transfers to different wards over the course of a year. Figures provided by Northumberland, Tyne and Wear NHS Foundation Trust.

322 234in Newcastle in Gateshead

Information about inpatient services over the year 2013/2014

C

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Y

CM

MY

CY

CMY

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Why things need to changeThis document should be seen in the context of the cross governmental national strategy for mental health ‘No Health Without Mental Health’, 2009.

In it, it highlights the four main ways of increasing value for money in mental health services:

• Improving the quality and efficiency of current services

• Radically changing the way that current services are delivered so as to improve quality and reduce costs

• Shifting the focus of services towards promotion of mental health, prevention of mental illness and early identification and intervention as soon as mental illness arises

• Broadening the approach taken to tackle the wider social determinants and consequences of mental health problems

In Gateshead and Newcastle, we want to ensure that services are high quality and as efficient as possible. They should be provided in the most appropriate, least restrictive environment, ideally supporting people well at home. We want to focus on supporting people to recover, and helping people with lifelong conditions to have fulfilling lives, so that every person can gain as much independence and control over their lives and their care as possible. This is in line with the national strategic direction for mental health services.

A small number of people will receive periods of care in hospital. We know that people who are in hospital with mental illness need to be treated in a different type of ward than people with mainly physical healthcare problems. This is because they may stay in hospital longer, they need different types of treatment and would not be ‘nursed in bed’.

Also it is important to remember that the environment needs to be safe from some risks to ensure that patients are not able to harm themselves or others.

‘No Health Without Mental Health’ also tells us: ‘Care and support, wherever it takes place, will offer access to timely, evidence-based interventions and approaches that give people the greatest choice and control over their own lives, in the least restrictive environment’.


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The physical environment of psychiatric wards is known to have a significant impact on people’s experience of spending time in hospital and in their recovery.

The Royal College of Psychiatrists describe this in their publication ‘Do the right thing: how to judge a good ward, Ten standards for adult in-patient mental healthcare,’ (June 2011).

‘The layout, design, decoration and ambience provided by the physical surroundings all play a role in fostering a therapeutic environment for both patients and staff. Access to fresh air is vital, as are quiet and private spaces on the ward and in outdoor areas’.

Building on this, there is considerable evidence that being a psychiatric in-patient is an unpleasant experience for many.

Overall, our aim is to avoid admission to hospital for people with mental health problems, unless it is absolutely necessary. People should have the opportunity to receive high quality services and support in their own homes wherever that is possible and safe.

In the publication, ‘In-patient Alternatives to Traditional Mental Health Acute In-Patient Care’, (January 2010) it highlights some concerns with in-patient services from a patients perspective.

‘Criticisms include that the physical environment is often poor and freedom greatly restricted, especially for the many who are compulsorily treated, opportunities for activity and exercise are limited.

The stigma associated with in-patient care further exacerbates this unpopularity: even where they think the environment and care received have been reasonable, patients often feel that the stigma associated with having been admitted to a psychiatric hospital is even greater than that associated with receiving a psychiatric diagnosis.’

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The national financial picture

Nationally, the NHS is facing growing demand and increased costs, it is on-track to deliver £20bn of savings by 2015, but this will not be enough. NHS funding is unlikely to increase, therefore in order to meet the challenges ahead, the NHS will need to reconsider how it delivers care and will have to undertake bold and transformative change in service delivery.

For CCGs, this means we have to review where we spend our money and what

outcomes are achieved in order to ensure we are getting the best quality and value for our patients

There is a national requirement for providers of NHS services to make efficiency savings every year, which in turn enables the CCG to fund demands for new services.

This efficiency saving is expected to be around 4% each year or 20% over five years.


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The local picture

About 98% of secondary mental health services in Gateshead and Newcastle provided by NTW services are delivered in the community, rather than in hospital.

This means a disproportionate amount of money is spent on in-patient services compared to specialist community services.

As shown in the graphic on page 10, in-patient services account for 43% of the money spent, while community services account for 57%.

This means that approximately 2% of patients are using 43% of resources at any one time.

We think it is important that community services are not reduced to make savings as they are needed to deliver the aims and aspiration for high quality recovery focussed care.

This does not mean that community services should stand still.

To improve the effectiveness of community services, NTW will have to fundamentally re-design the way they work, and how they work with partners, and other mental health care providers.

They will need to double the amount of time their staff are able to spend with patients to create more effective, timely and recovery focussed interventions.

By improving support in the community, and working collaboratively with providers, we aim to reduce the need for hospital admissions. This in turn would reduce the demand for beds.

This would enable NTW to meet the financial targets we’ve described by reducing the number of beds and wards available rather than reducing resources in the community teams.

Overall, we hope that any changes will see proportionately more resources invested in community services, and a cultural shift towards delivering recovery focussed services.

We want to understand what choices you would make about these services.

We want to understand what choices you would make about these services.

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Why is it important?

The vast majority of people using specialist mental health services receive their care outside of hospital.

On an average day (1st October 2014), 1178 people from Gateshead and 4491 people from Newcastle, were using specialist community mental health services.

On the same day, 38 people from Gateshead and 105 people from Newcastle were using specialist in-patient mental health services.

We need to make better use of the resources available. We want to protect community services from financial cuts wherever possible. Most importantly, we need to make sure that interventions are centred on the needs of patients and their carers, and are focused on helping people to recover and become as independent as possible.

NTW has been working closely with local partners, especially the local authorities to make initial improvements to community mental health services and this will continue, but also needs to be accelerated.

By doing this, we aim to support more people to stay well at home, rather than needing to be admitted to hospital.

The current specialist community mental health services

Currently, there are a number of different adult mental health teams which work across Gateshead and Newcastle. These include the community treatment team, assertive outreach teams, early intervention in psychosis teams, community rehabilitation team, crisis home treatment team, and initial response team (Gateshead).

We want to make it simpler for a GP or service user to understand how these teams fit together. We think it might be better if there was a single front door to these services.

Some teams work across more than one local area, for example some Gateshead teams are linked to Sunderland services, and this can be confusing.

Most of the teams have some level of working with local partners such as local authorities, the voluntary sector, and the police. We would like to make sure that the different services that people use always work together in the best way.

Improving specialist community mental health services (services outside of hospital)


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Recently we have seen that referrals to community teams have continued to increase, and the number of discharges for those teams has not kept to the same pace. This causes delays for new patients coming in, or at times when people might need extra help. This is at a time when funding for mental health services is reducing.

We also want to make sure that young people, who have a mental health problem identified in childhood, are supported through the transition into adult services. This transition is crucial for young people and their families and takes place at a time when there are many different changes happening in a young person’s life. We want to make sure that every young person who needs an adult mental health service has a smooth, and well planned transition which is based on their individual needs.

Also, in the past, it was not always clear what outcomes a service user could expect from their care. There is sometimes an expectation from society that someone with a mental health problem would always be a ‘patient’.

With support from the service user movement, expectations are changing. Services should now always be recovery focussed, identifying the interventions which will help the service user move towards maximum independence and

discharge from services. This requires all of the teams involved in care to work differently, and develop new ways to support and empower their clients.

What could be done differently in the future?

There are a number of elements of community service which we would like your views on. These are:

• Accessing services – for example having one number to call to reach NTW services, giving a quicker response in both planned and urgent situations

• More clinical time – this means more contact between the service user and doctors, nurses and other health professionals. Service will be available for longer, more flexible hours

• Better clinical interventions – more psychological therapies and treatment options

• Empowering patients and providing information – including sign posting to service user, carer and voluntary organisations

These issues were all highlighted as areas for improvement during the recent public meetings.

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Accessing services

When we held engagement events in September and October 2014, we heard people say that reaching NTW services can be difficult. People described that the crisis team had supported them well when they were in a crisis that fitted the criteria of the crisis team, but at other times they had not had an urgent response.

People said it was hard to know what type of support to expect when they first contacted the services.

One person said: ‘When first contact is made, staff need to be friendly, kind, humanistic and be on the side of the service user so they can learn to trust them, be reassured and not feel alone.’ (26th September 2014 event)

We need to better understand the different ways in which people want to make contact with specialist mental health services.

How do we ensure there is easy access, with few barriers when service users, carers, or professionals working with them need advice or support?

What can we learn from models elsewhere, including the initial response team that NTW has developed in the South of Tyne area?

We need to understand how young people and their families accessing adult mental health service for the first time would like to be supported.

How can we ensure good access without allowing scarce resources to be overstretched?

How can we create a single system where the response involves the right person at the right time in the right place?

In the short term, NTW are already working to streamline the way to contact services. They are also planning to accept and encourage self-referrals from both service users and carers. This will mean that any future enhancements to mental health service access which are suggested as a result of this engagement would be easier to implement.

More clinical time, longer hours, more flexible

NTW trust has mapped how doctors, nurses, and other clinical staff spend their time at work.

They have found that only about 25% of clinical staff time is spent having direct face to face contact with their patients. The rest of the time is spent on other activities such as updating clinical records, completing paperwork, training and driving to different appointments.

As a result NTW are making changes so that staff can spend at least 50% of their time in face to face contact with patients. They are doing this by reducing paper work and bureaucracy, and improving access to technology.

One way of doing this is to make sure that staff minimise their time driving by


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scheduling their clinical appointments more effectively. Another way is to reduce the time they spend typing by giving them resources to dictate information which can be typed by a secretary and checked by the clinician. This can dramatically increase the time a clinician has to see patients.

Currently most community teams work from 9am – 5pm, Monday to Friday and close at the weekends and in the evenings. NTW is looking at how this can be changed so that routine support is available from the community teams in the evening and at weekends.

Better clinical interventions – psychological therapies and treatment options

Providing the best clinical treatments is one of the most important aspects of any mental health team. Staff are being trained to deliver a wider range of standardised, best practice support and interventions. This means that patients will be able to get quicker access to the recommended treatments of their choice, enabling them to recover more quickly.

The CCG is also doing another piece of work looking at access to psychological therapies for people with the sort of mental health problems that are supported by their GP or primary care counsellor or therapist. These are more common mental health issues such as anxiety or depression and they are well treated by a GP with talking therapies and sometimes medication. If you have views about these services please contact us.

Empowering patients - providing better information

We want all service users and their carers to receive the same high level of care from every mental health service they use. For this to happen, they must have access to high quality information and support to enable them to prepare for and take control of their services and treatments.

Service users in NTW led the development of a range of resources which record their needs and preferences. This includes ‘Introduction to me’, a booklet which supports service users as they first experience mental health services. There is also a range of self-help guides which are available. This needs to be expanded to provide more information and include videos and other means of supporting people to understand local services.

Are these aspirations affordable?

The CCG has asked NTW if these aspirations are affordable and NTW has said that they can make some significant improvements to their specialist community services within the current budget.

However, it is important to remember that the amount of money available for mental health services is reducing overall, while demand is going up. Taking resources out of the community teams to meet this financial saving would undermine this work.

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Your views on community mental health services

We are keen to hear your views on community services. What is your experience of using community mental health services?

Please tell us which service you have used, whether this was as a service user or carer and what you think needs to be improved?

Questions to consider:

• We would like your views on how you would like to get in touch with local mental health services, so that we can understand what is most important to you.

• We would like to know what you think about using routine mental health services at the weekend or evenings. Do you think this would benefit you? What would you like to see included in these services?

• Do you have any views about psychological therapies that you have received through community mental health teams? If so, please tell us your views.

• We would like to hear from you about what would help you to take control of your mental health needs. How can services support you to be more informed and take more control?

• If you are a young person or a carer, how would you like to be supported through transition to adult services?

Developing a new vision for mental health services for Gateshead and NewcastleCase study

Let’s think about Malcolm.

Malcolm is 38 and has struggled with low mood and paranoid thoughts for most of his adult life.

He had a difficult upbringing, he left home at 16 and lived with mates, or at hostels and B&B’s. He took a lot of drugs and was in and out of prison for petty crimes, especially theft.

Recently, Malcolm had become more settled and is living in a flat with some support.

He has been becoming more paranoid and thinks people are talking about him. He hears the voices of his mum and dad criticising him and telling him he’s useless.

Dr Guy Pilkington says:

“Malcolm’s story is one of those we want to change. Improvements in community services will increase the amount of time that staff have to spend with patients like Malcolm, who are currently less likely to receive regular support.

In future, we would like Malcolm to have more contact with a range of professionals, to understand his problems, earn his trust and work with him to identify his goals for recovery. At times this might be with a community psychiatric nurse, a peer support worker, or other community support.

There is good evidence that talking therapy could help Malcolm’s wellbeing. He is likely to need more in-depth talking therapy than is currently available to most people.

We would also like to see Malcolm being offered other types of support – to help him with his housing, benefits, or to get a job – things that we know will help him to stay well in the future.”

Malcolm drinks a lot to stop the voices. He is often picked up on the streets by the police and is taken to A&E.

He has seen a psychiatrist in the past and they put him on medication. He stopped taking it as it made him put on weight and he didn’t see the point.

He has seen different GP’s over the years, but has given up hope. He has been referred to community mental health teams, but he sometimes missed appointments with them, and when he does go to the appointments, it tends to be when he’s feeling ok. He doesn’t really feel that the nurse is that bothered about him.

This time when he goes to the GP, they ask him to rate his mood on a scale of one to ten. It’s one.

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In-patient services are an essential and increasingly specialised area of mental health provision. Only a very small number of people with a mental health condition will ever need to spend time in hospital, but those people will have higher levels of need, risk and complexity. Their care and support for their families at this critical time is very important.

The current in-patient services

In-patient psychiatric assessment and treatment services for local adults of working age are currently provided at the following locations:

• The Tranwell Unit, Queen Elizabeth Hospital Gateshead

• The Hadrian Clinic, Newcastle General Hospital

• Some patients from Gateshead and Newcastle already use services at St George’s Park in Morpeth and Hopewood Park in Sunderland

These services provide intensive 24 hour support for adults with very serious acute mental health problems such as severe depression, schizophrenia, and psychosis.

As a general rule, men are more likely to require an in-patient admission for these sorts of illnesses than women.

People only need to be admitted to hospital when home or community treatment is not possible or appropriate due to the risk to either themselves or to other people around them. The majority of patients are detained in hospital under the Mental Health Act 1983.

Currently a patient from Gateshead or Newcastle who is admitted to hospital will not necessarily go to the closest hospital. The infographic on page 11 shows how many local people already go to hospitals which are further away.

This may be due to a number of factors, one of which is the amount and the type of beds that are available in particular wards.

Potentially relocating the current adult in-patient units in Gateshead and Newcastle, and reducing bed numbers overall


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Other reasons are:

• Their own choice, some people request to go to a hospital closer to their family, or where there are better facilities

• Clinical needs and levels of risk, it may not be safe to care for people in some wards due to the way they present when unwell and the lack of back up services on some of the more isolated wards

• The mix of patients on each ward

The services in Gateshead and Newcastle are both small units on larger hospital sites which are owned by other NHS Trusts (they are not NTW sites).

In Gateshead, the Tranwell Unit has two wards:

• Fellside is a 20 bed acute admissions ward for men

• Lamesley is a 18 bed acute admission ward for women

It is based at the Queen Elizabeth Hospital, a general hospital site which is managed by Gateshead Health NHS Foundation Trust.

In Newcastle, the Hadrian Clinic has three wards:

• Gainsborough is a 16 bed acute admissions ward for men

• Collingwood@Hadrian is a 16 bed acute admission ward for men

• Lowry is a 16 bed acute admission ward for women

The Hadrian Clinic is based at the Centre for Aging and Vitality (Newcastle General Hospital site) which is managed by the Newcastle upon Tyne Hospitals NHS Foundation Trust.

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Current challenges

The quality of the care provided in all of these services is not in question. All have achieved the prestigious Accreditation for In-patient Mental Health Services (AIMS) from the Royal College of Psychiatrists which recognises the quality of care provided. Fellside, Lamesley, Gainsborough, and Lowry wards are all accredited with Excellence.

They are regularly inspected for cleanliness through the PLACE (patient led assessments of the care environment) annual visits and weekly inspections.

Most importantly, during our initial engagement with service users, there were a number of patients who expressed strong views that the care they have received as an in-patient in these units has been very compassionate, caring and effective despite the limitations of the building. It is a real credit to staff who work on those units that these high standards have been maintained.

Nevertheless, these buildings are not the sorts of environments that we would wish to have as in patient facilities. Inspections by both commissioners and the Care Quality Commission through Mental Health Act visits have highlighted that the buildings are not up to the standards required for modern care. This is a view shared by both the CCG and NTW.

These wards are relatively isolated, with no surrounding mental health wards. This means that there are no additional clinical

or support staff who can support patients and staff to stay safe in situations when a patient might become more challenging.

This means that some patients who are assessed as being more challenging are unable to be safely cared for in these locations, so are admitted elsewhere.

The wards have been criticised for a shortage of bathrooms and do not have any en suite facilities. Some patients opt to be admitted to a ward further away from home because they prefer the environment and facilities on those wards, such as having an en suite bathroom and more privacy.

Clinical observation of patients can be difficult due to the design of some wards, and this can mean that patients are more restricted in their activities than they would be in a more modern ward. In particular access to outside space and pleasant rooms for visitors is a problem. Also some rooms have ‘blind spots’ which are addressed by mirrors, but this is not ideal, and increases risk. We also know it is increasingly difficult to recruit clinical staff to work in these poorer environments.

Continuing to provide effective services in these environments is very challenging - for these reasons, NTW would wish, in time, to come off both these sites.

At the initial engagement events we heard a range of different views about in-patient services. These included:


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Comments about hospital environments: “Hadrian Clinic is a horrible environment” “Having privacy and dignity massively affects your ability to recover. Facilities such as en suite bathrooms make a big difference.”

Comments about the limitations of hospital services: “The Tranwell was a revolving door for me, I had been there lots of times. Then I went to a specialist hostel with different one to one support that challenged me. I’ve never been back to hospital because of the support I got there”

Comments about location of hospital services: “When you are acutely ill geography does not matter, however as you begin to recover visiting hours are problematic to family and friends and although it can be difficult if your support structures are not around, in some cases the support structures themselves can hinder recovery.”

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Over the last 30 years, service users, their advocates and politicians have worked hard with NHS organisations and other partners to make sure that people with mental health problems are no longer expected to live in hospitals or other institutions.

In the early 1990s, services were encouraged to place mental health wards on general hospital sites, alongside physical health services, as was the case with the Tranwell Unit and Hadrian Clinic. This was in an attempt to reduce stigma and move further away from institutions.

Nowadays, we find ourselves in a different position. As we have explained in this document, there are now much smaller numbers of people who need to be admitted to hospital due to their mental health condition. Those people who do need to be admitted have very high levels of need; require much more intensive support; are more likely to be detained under the mental health act and are likely to be in hospital for a shorter time.

We know that support from family and friends are important to people in hospital and we want to continue to support patients to maintain positive relationships.

We also know that people in hospital want to be there for the shortest amount of time, to have high quality environments, to feel safe, to be occupied and to receive intensive treatment so that they can recover quickly.

We would like the hospital environments to be fit for providing an up to date service which promotes recovery and safety. This means that patients should have ensuite bedrooms, access to a patient’s bank, activity rooms, visiting rooms and good facilities for families. We would also like to ensure easy access to outside space, fresh air and quiet areas from all wards.

These wards should be supported by other similar services which can offer support in an emergency, and other important clinical services such as an on-site pharmacy. Importantly, we would like to ensure the same level of clinical support from medical staff seven days a week rather than relying on doctors who are ‘on call’ overnight and at weekends.

We would also like to ensure that patients are supported by their families, and are able to keep in touch with their friends whilst in hospital.

A strong message has been that people do not want to go into hospital if they can avoid it. They want to be helped early, before they become so ill that they need to spend time in hospital.

Several people at the service user events suggested that there was a need to have different types of services, other than hospital for people who are becoming unwell.

One person said: “I needed to go somewhere that wasn’t my own four walls, I could feel myself getting worse and worse, but I had to wait until I was so ill that I was admitted.”


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In-patient services are inevitably more expensive than community services for a number of reasons. The buildings themselves are a significant cost as are the support services which are required such as catering, security, laundry, pharmacy etc. On top of that, the nursing and other clinical staff required to operate a ward safely 24 hours a day are largely fixed and cannot be reduced.

NTW have said from a clinical perspective that they would prefer to make required cost improvements from in-patient services rather than from community services.

Doing this would demand reducing the number of sites for in-patient care, and the number of individual wards. For example, they suggest that providing services from two main hospital sites, rather than three main hospital sites across the trust area would save between £8.5 and £10 million per year to meet the same level of demand.

However, we have already heard from local people at the early engagement events that they value local in-patient services, and are very worried about keeping in touch with family and friends if in-patient services are further away. They told us that they would like services to be delivered as close to home as possible, and they would like to be supported better in the transition from home to hospital and back home again.

Local GPs and community clinicians have asked NTW to think about the importance of good pathways between community and hospital services, and also the importance of good relationships between community doctors, hospital doctors and GPs.

This is a very important part of the consultation and we need your views on what you think are the most important things to consider in this complicated and important area.

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Case study

Let’s think about Jessica.

Jessica is 28 and has been receiving support from community mental health services for five years. Shortly before that, Jessica’s mum died, and she became very depressed. She found that she could not cope and felt that she was a burden to her family.

She tried to take her own life. Fortunately she was found by her family and taken to A&E, they called the crisis team. Jessica was admitted to hospital.

Over the past five years, Jessica has been admitted to hospital a number of times for short periods when she has been very unwell.

Her first admission was to the Tranwell Unit, and her second was to St George’s Park Hospital in Morpeth.

Jessica has therefore had experience of the much better facilities and environment at St George’s Park Hospital, but at the expense of being further away from her home in Gateshead.

Her Dad, who is disabled from a stroke lives in North Tyneside. He visits Jessica every week and has a taxi provided for these visits as he isn’t able to drive. Jessica’s partner also visits regularly and brings her daughter to see Jessica. They do have a car, and are able to get to either hospital for visits.

At St George’s Park Hospital Jessica can see her partner and daughter in a room which is welcoming and suitable for children. They are also able to get outside and enjoy some time together in the gardens or in the café.

Currently there is a choice to be made between local, but less suitable hospital accommodation, and much better accommodation about 20 miles away.



• We would like to hear from you about what is important to you about in-patient services

• How much do you value the environment for in-patient care such as en suite facilities and areas for visitors?

• What are your concerns about travel and transport for service users and carers and relatives?

Your views on in-patient services

If you or a family member has had experience of in-patient services, we would like to hear your experiences, what worked well and what could be improved.

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The current service

The Tranwell Unit and St Nicholas Hospital in Newcastle include a ‘section 136 suite’ as required under the Mental Health Act 1983.

If a police officer finds any person in a public place who they believe is mentally ill and in need of immediate care or control, the officer is allowed to remove them to ‘a place of safety’ which can be the 136 suite. This can be because they are acting in an unusual manner, posing a risk to themselves, or many other reasons. At the 136 suite the service user will be assessed under the Mental Health Act. In the majority of cases, the person will then be allowed to go home without being detained further.

As part of this process, we would like to consider the best alternative arrangements for the 136 suite in Gateshead and Newcastle and wider improved working with the police.


In some areas, including Gateshead, ‘street triage’ teams now operate to provide a better alternative to removing people to a a place of safety under section 136.

Street triage aims to reduce inappropriate detentions by creating a much closer working relationship between the police and mental health services. Dedicated teams of police officers work alongside mental health nurses at core hours so that the right steps can be taken to support people and good advice and information can be given. This includes detail about the person involved and their medical history so they receive the help they need.

Reducing the number of 136 assessments would lead us to think carefully about the best location for remaining 136 suites.


Yes, early evidence suggests that providing street triage is significantly better value for money than the current arrangements of detaining more people than necessary under section 136.

Ensuring a place of safety - section 136 suites

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Let’s think about Mik.


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Case study

Let’s think about Mik.

Mik is a young man who lives in a hostel in the east end of Newcastle. He is regularly picked up by the police for behaving in an unusual way around Byker Bridge. Members of the public often ring the police to report his behaviour because he suggests that he might hurt himself and can be quite frightening to people who don’t know him. When the police approach he can become aggressive or can run away.

The police respond by detaining Mik under a section 136.

He is taken to the 136 suite at St Nicholas’ Hospital. When the police arrive at the suite

there can be a delay while they wait for the nurse, doctor and approved social worker, to arrive to do the assessment. None of these staff are based at the 136 suite.

Sometimes the police will wait for a long time before they can hand responsibility for Mik over to health services. This can make Mik very frustrated and agitated.

Mik will then be given a full mental health assessment to determine if he is unwell, and the level of risk he poses to himself and others. Mik has never been admitted to hospital following an assessment, as his level of mental health need is relatively low. So following the assessment he is able to go home. Staff often suggest that he goes to see his GP to get some more consistent help./


• Do you have experience of using the section 136 suite in Gateshead or Newcastle? What would be your priority for improvement?

• Do you have any other views about the provision of urgent mental health services involving the police?

Your views on a place of safety

If you or a family member has had experience of section 136 suite, we would like to hear your experiences.

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There are some services which meet the very complex and specialist needs of a small number of people. These services are:

• Psychiatric intensive care unit

• Rehabilitation service for people with complex mental health needs including high dependency unit, longer term complex care rehabilitation unit and ‘moving on’ units

Psychiatric Intensive Care (PIC) Services

Psychiatric Intensive Care, Good Practice Commissioning Guide, Department of Health, 2012 describes this service as a:

“Small, highly staffed facility, which provides short periods of intensive treatment for adults requiring rapid assessment and stabilisation during or before a period of in-patient care.

The emphasis is on intensive treatment combined with a range of physical, procedural and relational security

measures that will help reduce risk, disturbance and vulnerability.”

Patients requiring PIC are likely to:

• Display acute behavioural disturbance that seriously compromises their physical and/or psychological wellbeing of themselves and/or others

• Be at notable risk of aggression, suicide and/or serious self-harm

• Be at increased vulnerability because of sexual disinhibition or over activity in the context of mental disorder.

The good practice commissioning guide also sets out in detail the requirements of a psychiatric intensive care unit, in terms of the environment, the facilities which should be available, risk management and safety and other detail.

Currently the psychiatric intensive care unit for people from Gateshead and Newcastle is provided in a purpose built unit at Hopewood Park in Sunderland. This specialist facility with 14 beds serves the needs of the total Northumberland, Tyne and Wear population.

Services for people with especially complex mental health needs


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Your views on Psychiatric Intensive Care (PIC) Services

If you or a family member has had experience of using the PIC, we would like to hear your experiences, what worked well and what could be improved.

Rehabilitation service for people with complex mental health needs

Mental health rehabilitation services specialise in working with people whose long term and complex needs cannot be met by general adult mental health services.

The Joint Commissioning Guidance from November 2012 sets out that these services should provide specialist assessment, treatment interventions and support to help people recover from their mental health problems and regain the skills and confidence to live successfully in the community with improved functioning and quality of life.

The guidance highlights that there is a group of service users with very complex needs who require highly specialist in-patient and community rehabilitation services. These service users are a ‘low volume, high needs group’; 80% will have a psychotic illness and most will have been repeatedly admitted to hospital prior to referral to rehabilitation services.

Local need

National and international evidence show that even with the best of early intervention in psychosis services around 10% of service users presenting to mental health services for the first time with a psychotic illness will go on to require rehabilitation services due to the severity of their functional impairment and symptoms.

Based on figures for the number of people from Newcastle presenting to NTW with first episode psychosis between April 2010 and April 2014 this would be 12 new patients a year requiring rehabilitation services. For Gateshead this would be 6 new patients a year. Most of these service users will require an extended admission to hospital in-patient rehabilitation services and ongoing support from specialist services over many years.

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Guidance states that “an effective rehabilitation service requires a managed functional network of services across a wide spectrum of care with exact components determined by local need. These comprise in-patient rehabilitation units for those detained under the Mental Health Act (1983) including high dependency unit, complex care and ‘moving on’ units as well as community rehabilitation teams, supported accommodation services and services which support service users occupation and work.” Not all of these services will be provided by the NHS.

Guidance also emphasises that “pathways through these services should be as seamless as possible with good working relationships between the components” and suggests that “commissioners play a key role in facilitating these relationships”.

Specialist rehabilitation services are expensive, typically absorbing around 25% of the total mental health budget, but they are very important.

A recent study in Ireland found that people with complex mental health needs were eight times more likely to achieve or sustain community living if they had been supported by specialist rehabilitation services, than if they were supported by general adult mental health services. It is therefore important that money for this group of services users is spent effectively.

There is acknowledgement in this guidance that some services should be provided locally and others on a wider footprint, due to the number of service users requiring different parts of the pathway.

The chart opposite sets out the different types of rehabilitation units and their current location:

Positively, even amongst those with complex problems the majority (two out of three service users) are able to progress successfully to supported community living within five years. Around 10% of these will achieve independent living.


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Unit Recovery goal SiteLength of admission

Degree of specialisation

High dependency unit To move onto a community rehabilitation unit or to supported community living

Hospital based to benefit from support from other wards

1 – 3 years One unit for a population of 600,000

Complex care unit patients will have high levels of disability, complex co-morbidity and risk with limited potential for gaining skills required for supported community living

Emphasis on promoting personal recovery, social and interpersonal functioning with the aim to move to a more domestic settling (for the most chronically disabled).

Hospital or community based

5 – 10 years One unit for a population of 600,000

‘Moving on’ unit.People with complex needs who cannot be discharged directly from hospital to an independent or supported community placement due to ongoing high levels of need.

To achieve a successful return to independent living ie supported tenancy.

This is achieved through optimising medication regimes and psychosocial interventions.

Mixed provision with hospital based and community based move-on facilities.

1-2 years One unit is needed for a population of 300,000 population

Community rehabilitation team

Enable clients to gain confidence in everyday living skills, self management of illness and treatment and day to day life. Supporting major transitions.

Community based

Ongoing as required

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In Gateshead and Newcastle, the main services that people with this level of need will access are:

Male high dependency unit

This is a new service based at St George’s Park Hospital, which was opened in 2014. It has 18 beds, and provides a service for men from Newcastle, North Tyneside and Northumberland. There is a second male high dependency unit at Hopewood Park in Sunderland.

Female high dependency unit

This service is provided from Hopewood Park in Sunderland. It has 18 beds and provides a service to women from across Northumberland, Tyne and Wear.

Complex care unit

This service is provided at Kinnersley at St George’s Park. It has 21 beds and provides a service for both men and women from Newcastle, North Tyneside and Northumberland.

Another complex care unit is provided by NTW at Hopewood Park Hospital, Sunderland.

Moving on units

There are currently two moving on units locally:

Willow View at St Nicholas’ Hospital has 15 beds and provides a service to men and Women from Newcastle and North Tyneside.

Elm House in Bensham has14 beds for men and women, mainly from Gateshead.

Other moving on units are provided by NTW at St George’s Park in Morpeth, and in Sunderland.

Community rehabilitation service

The community rehabilitation service provides care, treatment and case management for those people living in the community. This can involve supporting people in all of the different areas which contribute towards their recovery and also supporting change and transitions for the most vulnerable. One crucial transition is moving into community living after a necessary extended period in hospital. There is good evidence to show that the community rehabilitation service has been able to successfully support this transition, ensuring successful discharge at the right time for each individual and reducing risk of relapse.

We want to be able to provide rehabilitation services which truly support people in their personal recovery. We need to avoid people becoming ‘stuck’ in hospital based services by providing a pathway which responds quickly to changing needs, and which always works towards moving on to the next step in the person’s recovery journey.

Providing moving on units in community settlings has both pros and cons. Easy access to community resources like shops and leisure facilities is a good thing. However, moving on units which have support from other hospital services


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means that people with a higher level of need and risk can access rehabilitation earlier in their recovery journey. Accessing a rehabilitation bed earlier improves outcomes and also means more people overall are able to benefit from being supported in a less restrictive environment.

We value the support that many people with especially complex needs receive from the community and voluntary sector, particularly as they move into independent or supported living. We know that the NHS does not need to provide these types of services. Instead, the NHS needs to work in partnership with the community

and voluntary sector, offering health expertise and input.

We are keen to ensure that we get the best value for money, in the light of decreasing resources. Currently the vast majority of services for people with especially complex needs are in-patient based and we are eager to protect the community elements of the service from financial savings.

We also want to avoid unnecessary and expensive out of area placements being required for this group of service users wherever possible.


The high dependency unit and complex care units are provided in one location for the North of Tyne area as prescribed by commissioner guidance.

• Do you have any views about how we can support people who use these services more effectively?

• Do you have any views about how families of people using these services can be better supported?

Your views on rehabilitation service for people with complex mental health needs

If you have used or cared for someone using psychiatric intensive care services, and you have an experience you would like to share, we would very much like to hear it.

In Newcastle, services for older people with a mental health problem are provided by NTW. This includes:

• Older people’s community mental health team

• In-patient wards – both for older/more frail people with a mental health problem and assessment and treatment for those with dementia. Both of these wards are at the Centre for the Health of the Elderly at the Centre for Ageing and Vitality (formerly Newcastle General Hospital)

In Gateshead, services are provided by a different health trust.

For these services, NTW would like to apply the same principles of improving community services to ensure more people get more help sooner, and at the same time improving the accommodation from which in-patient services are provided.

Increasingly adult mental health services are ‘ageless’. This means that there is not a fixed cut off point when a person will move from ‘adult’ into ‘older peoples’ services. Instead, services will be offered based on a person’s needs. For example a 68 year old man who has a long term condition like schizophrenia and is otherwise fit and healthy could continue to be seen in adult services.

A 59 year old lady who has developed challenging behaviours due to dementia

would most likely be supported by the older people’s teams.

As with adult services, the vast majority of older people with a mental illness or with dementia live in their own homes, or in other supported accommodation in the community. They may receive support from local councils or from other local groups.

Services for people with dementia

We believe that people with dementia should not live in hospital. They should be supported to live as independently as possible outside institutional care. When people need to live in residential of nursing homes, we will work with colleagues in the local authorities to ensure that their health needs and other needs are met. Over recent years the number of long term care hospital beds for people with dementia has decreased. This is primarily due to development of specialist teams who support people with challenging behaviour in nursing or residential care homes, or, where possible, in their own home.

In-patient services for people with dementia need to be purposely designed for their specific needs. We know that in-patient services which are specifically designed with dementia in mind result in fewer falls and incidents, support people to be more

Services for older people

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(Newcastle only)


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independent, and have many other benefits for those service users.

The University of Stirling provides accreditation of dementia friendly environments and highlights good practice in this area. The current in-patient services for people with dementia in Newcastle do not meet this standard. The ward is based at the Centre for the Health of the Elderly at the Centre for Ageing and Vitality (formerly called Newcastle General Hospital). It provides a service to both men and women and suffers from a lack of space and privacy. The rooms do not have en-suite bathrooms, there is limited space for visitors and poor access to outdoor areas and fresh air.

Services for older people who are frail or have complex problems

Some older people need a different type of specialist in-patient mental health service. This might be because they are frail, or have

complicated physical health problems which impact on their mental health. Up to a third of people who use this type of service will have a level of dementia as well.

We would like to make sure that community services are able to support as many older people as possible, and avoid unnecessary admissions. The patients who are admitted to these wards usually have very complex health needs as modern community services are able to support people at home for longer.

When people do need to be treated in hospital, it’s important that the environment supports their recovery. Staff need to be able to support higher numbers of people who present very challenging behaviour, as well as people who are very frail and this is difficult to achieve. Good sleeping accommodation, private bathrooms, easy access to outdoor space and fresh air all help. Private space for visitors is also very important to enable patients to keep in touch with their families.

Questions to consider:• We would like to understand what is most important to you about receiving

care if you are an older person, or a carer of someone who is older.

• Have you or your family used in-patient services for older people in Newcastle? Were these dementia services (Castleside ward) or services for frail elderly people (Akenside ward)?

• Have you or your family used community older people’s services in Newcastle?

• Have you had good or bad experiences of care that you would like to tell us about? How do you think services could be improved?

Your views on services for older people (Newcastle only)

If you have used or cared for someone using services for older people, and you have an experience you would like to share, we would very much like to hear it.

Across Gateshead and Newcastle, and indeed across the country, the vast majority of mental health services are delivered in the community. Often these services are based at clinics in community bases, and many people with a complex mental health need will be seen in their own home.

It is not unusual for people to travel outside of their own locality for in-patient psychiatric services. Some people choose to travel further away from home so that they can receive a service in a more modern hospital with better facilities.

NTW has introduced new systems and arrangements for patients and carers so that in-patient services remain accessible to patients and their families – even when they are further away from home.

On admission to hospital, every patient is asked about travel issues for them and their family and carers.

This enables ward teams to support patients, families and their relatives with their individual situation.

Wards have a number of resources available to help including ward cars which can be used by support staff to transport patients. Staff can also arrange for taxis to be provided in line with NTW policies, and can give information about public transport and grants if that’s appropriate.

These arrangements are available now, and apply to patients who are receiving care outside of their local area, and their families.

As part of this consultation, the CCG will work with NTW to understand how far patients from Gateshead and Newcastle, and their families currently travel to wards.

They will also be talking to local community staff to understand how they are affected when patient’s need to spend time in hospital further away from home.

Transport and travel

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Question to consider:

• How far do you think it is appropriate to travel to an in-patient service?

Your views on travel and transport

If you have had to travel for care or treatment, or visit someone and you have an experience you would like to share, we would very much like to hear it.

Current distances between existing wards: (source: Google Maps by shortest route)

From Tranwell Unit, Gateshead:

To St Georges Park, Morpeth 20.4 miles

To Hopewood Park Hospital, Sunderland 13.8 miles

From Hadrian Clinic, Newcastle

To St Georges Park, Morpeth 16.4 miles

To Hopewood Park Hospital, Sunderland 18.9 miles

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What do we need to know from you?Throughout this document we have highlighted some key questions around each of the issues being considered.

However, we do not think that they cover everything – so if you feel we have missed something or there is an issue that is important to you, then we want to hear what it is.

We have set out a number of ways for people to get involved and our intention is to make it as easy as possible for people to do so. These are listed below.

We are particularly keen to hear from patients, service users and carers with experience of mental health services in Gateshead and Newcastle.

If you are happy to do so, please tell us about your experiences and how they might be different in the areas we describe here in this document.

We will keep all responses that describe patient experiences confidential.

If you have ideas or suggestions on how care or services might be done differently, again please share them with us.

We would also like to hear from groups or organisations involved or interested in mental health issues. We would welcome both individual and organisational responses.

During the winter we are happy to attend local meetings. If you would like us to attend your meeting please let us know.

Ways to get involved and give your views:

Take part in the surveyWe have designed a survey to make it easier for people to give their views and describe experiences. This is available both in paper format (with a free post address) and online at www.newcastlegatesheadccgalliance.nhs.uk

A paper version should be included in the back of this document. If there is not a survey then please contact us and ask us for a copy.

Attend a market place eventSix market place events, with different topics for each stall, will take place from November 2014 to February 2015. The timetable for this is shown opposite.

Attend ‘how we can spend the Gateshead and Newcastle mental health pound’ event You will have the opportunity to find out more about the money available for mental health care and services and give your views on how you think is should be spent.

This event will take place in January 2015 and pre-registration is required.

If you are interested in this, then please contact us and quote: ‘mental health pound’.


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Attend a focus groupFocus groups will take place across a range of topics. If you would like to attend one please register for your interest through our website under the ‘deciding together’ section and join ‘MY NHS’.

Please remember to tick ‘mental health’ as your area of interest. You can also complete and return the MY NHS application form the survey document.

Run a focus groupWe are seeking third sector groups and organisations willing to run focus groups around the issues and themes highlighted in this document in return for a small payment. All materials and guides will be provided.

Please contact using the details shown on the back cover and quote: ‘run a focus group’.

What will happen next?We will analyse the information we are receiving from the various engagement methods and publish reports in two stages – in December and then in February so we can share with everyone the issues, ideas and themes that emerge.

This information will inform the development of scenarios for change which will be subject to a formal consultation period in 2015.

You can keep involved and informed about how this progresses by joining My NHS using the form in the survey document.

Deciding together event timetable:

Date Time Event

Wednesday 12 November

11am-12am 12pm-4pm

Launch event Market stalls: Assembly Rooms, Newcastle upon Tyne, NE1 5XU

Thursday 20 November

10am-1pm Market stalls: Gateshead Civic Centre, Regent Street, Gateshead, NE8 1HH

Thursday 4 December

1pm-5pm Market stalls: Newcastle Central Library Bewick Hall, 33 New Bridge Street West, Newcastle upon Tyne, NE1 8AX

Wednesday 14 January

10am-1pm Market stalls: Gateshead Civic Centre, Regent Street, Gateshead, NE8 1HH

Saturday 17 January

How can we spend the Gateshead and Newcastle mental health pound? Please contact us for details

Thursday 22 January

1pm-4pm Market stalls: Life Conference & Banqueting, Centre for Life, Times Square, Newcastle upon Tyne, NE1 4EP

Thursday 29 January

4pm- 7pm Market stalls: Assembly Rooms, Newcastle upon Tyne, NE1 5XU

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NHS Gateshead Clinical Commissioning GroupNHS Newcastle North and East Clinical Commissioning GroupNHS Newcastle West Clinical Commissioning Group

Newcastle Gateshead Alliance

Transforming lives together Transforming lives together Transforming lives together Transforming lives together

Contact us:All information is on our website or you can contact us via:

Email: [email protected]

Telephone: 0191 217 2670

Website: www.newcastlegatesheadccgalliance.nhs.uk

Follow us on Twitter: @NGallianceccg or #decidingtogether

Like us on Facebook - search for: deciding together

Alternatively you can also write to us at:

FREEPOST RLSH-KHYU-YREH NHS (NECSU) Deciding Together, Riverside House, Newburn, Newcastle upon Tyne, NE15 8NY

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Developing a new vision - NHS Newcastle Gateshead CCG · 2016-07-12 · Developing a new vision for...

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