Central and North West London

NHS Foundation Trust

Building Better Mental Health Care

Central and North West London NHS Foundation Trust
Consultation Summary

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Welcome
This document summarises the changes Central and North West London NHS Foundation Trust
(CNWL) are proposing to make to mental health hospital services in the Royal Borough of
Kensington and Chelsea (K&C) and the City of Westminster.

The Trust wants to:

• Improve the quality of inpatient care and experience

• Ensure timely discharge from hospital using the recovery model
• Involve service users and carers from the outset
• Continue to provide more care for those suffering from mental illness to be delivered out
of hospital.

We are writing to you because we want to know what you think of our plans.

In this document, you can find out more about what we are proposing, why we believe that we
need to make changes and how you can get more information on the development of these plans.

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 About us
Central and North West London NHS Foundation Trust specialises in caring for people with
mental health problems, addictions and learning disabilities across London, as well as providing
community health services to residents in Hillingdon and Camden, and primary care services in a
number of prisons.

Why change?
We want to continue to treat more people with mental illness through community services
rather than in hospital.

Research has told us that we have a high level of inpatient beds available compared with other
similar trusts. Having recently concluded a successful pilot in which inpatient beds were reduced
in Kensington and Chelsea, we feel there is scope to redesign our services so that we have the
right amount of beds available to meet needs.

Our commissioners, NHS Inner North West London and the Clinical Commissioning Groups have
said that they would like to see a greater use of community services and a reduction in the use
of inpatient beds. Providing care in this way supports commissioners’ QIPP (Quality, Innovation
Productivity and Prevention) plans. These are plans which drive improvements in the quality of
care while delivering nationally required efficiencies.

We are tasked with delivering significant cost savings across our Acute Services over a three year
period and these plans will enable us to do that as well as providing better care.
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Central and North West London NHS Foundation Trust acute inpatient bed breakdown

Borough Site Acute bed no. Male PICU Female PICU Total bed no.
Brent Park Royal 66 10 0 76
Total Brent Total Brent 66 10 0 76
Harrow Northwick Park 45 45
Park Royal 0 2 2
St Charles Hospital 0 1 1

Total Harrow Total Harrow 45 2 1 48

Hillingdon Riverside 41 8 49
St Charles Hospital 1 1
Total Hillingdon Total Hillingdon 41 8 1 50
K&C SK&C 28 28
The Gordon 4 4
St Charles Hospital 27 8 2 37
Total K&C Total K&C 55 12 2 69
Westminster The Gordon 59 8 67
St Charles Hospital 40 6 4 50
Total Westminster Total Westminster 99 14 4 117

Total CNWL Total CNWL 306 46 8 360

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 Central and North West London inpatient sites by borough

PICU Ward

Inpatient sites

Harrow

Brent
Hillingdon

Westminster

K&C

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The preferred option
We are proposing to:

• Permanently close Mulberry North Ward at South Kensington and Chelsea Mental Health
Unit - 13 acute bed reductions
• Reduce the number of Westminster beds at St Charles Hospital – 15 acute bed reductions
• Move the provision of beds for Kensington and Chelsea patients from Mulberry South Ward
to St Charles Hospital - service move
• Close Belgrave Psychiatric Intensive Care Unit (PICU) at the Gordon Hospital, Pimlico – 12
male PICU bed reductions (eight Westminster, four Kensington and Chelsea at present)

This means a total reduction of 40 beds across three wards, which would result in the revised
provision of beds shown below.

Beds per
Weighted
No. male PICU 100,000
Borough No. acute beds Total beds population
beds heads of
population

K&C 42 8 50 180,570 28
Westminster 84 6 90 238,485 38
KCW Total 126 14 140 419,055 33

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 What changes are we making to support our service redesign?
The following changes will be made to ensure the service redesign brings improvements for
service users in many areas, including:

• Triage wards across both boroughs which have proved successful in other Trusts
• Dedicated inpatient consultants with much greater involvement of senior medical staff
• An appropriate complement of multidisciplinary skills for each team
• Home treatment teams (HTTs) to enable more patient recovery at home
• Acute services and recovery teams continuing to working together
• Better patient flow and discharge planning to allow patients to be discharged as soon as
they are well enough.

What we see as the benefits of our preferred option

CNWL remains committed to providing inpatient beds for anyone who needs an admission.
If the plan is approved progress will be monitored continuously. If service provision, safety or
quality are compromised at any time the project will be halted whilst a review is undertaken of
its continued viability.

Some of the key benefits of this option include:

• The fewest bed reductions but there are still financial benefits
• The majority of inpatient beds will remain within the home borough and there is a site
physically located within all boroughs
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• Reduces the number of sites Acute Services operate from, maximising the savings
derived from overheads and facilities costs rather than direct patient care functions
• The most feasible in terms of interfacing with other service lines
• Offers the potential to re-use or dispose of vacant premises
• Impacts on the fewest number of staff.

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 Further information and how to respond
For further information or to submit a response about the consultation please contact us on
020 3315 6013 or email acute.serviceline@nhs.net

The questionnaire is available to download at www.cnwl.nhs.uk/consultations.html

Building Better Mental Health Care Consultation

Freepost RSTJ-LART-UBYA
CNWL NHS Foundation Trust
Stephenson House
75 Hampstead Road
London, NW1 2PL

This consultation will run from 24 August to 16 November 2012, so please return your
response to us by this date to ensure that your views are taken into account.

We will be holding two public meetings to discuss these consultation proposals on:

Monday 10 September 6pm: Cockburn Lecture Theatre, 2nd floor, Queen Elizabeth the Queen
Mother Wing, St Mary’s Hospital, South Wharf Road, London W2 1NY

Wednesday 12 September 6.30pm: Small Hall, 1st floor, Kensington Town Hall, Hornton Street,
London, W8 7NX

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We hope you are able to come along. We will add details of additional meetings to our website
as soon as they become available: www.cnwl.nhs.uk/consultations.html

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 This document is also available in other languages, large print, Braille and audio format
upon request. Please email acute.serviceline@nhs.net

Dokument ten jest na życzenie udostępniany także w innych wersjach językowych,

w dużym druku, w alfabecie Braille’a lub w formacie audio

Mediante solicitação, este documento encontra-se também disponível noutras línguas,

num formato de impressão maior, em Braille e em áudio.

Dokumentigaan waxaa xitaa lagu heli karaa luqado kale, daabacad far waa-wayn, farta
indhoolaha (Braille) iyo hab dhegaysi ah markii la soo codsado.

Be belge istenirse, başka dillerde, iri harflerle, Braille ile (görme engelliler için) ve ses
kasetinde de temin edilebilir.

12 Central and North West London NHS Foundation Trust, Stephenson House, 75 Hampstead Road, London, NW1 2PL www.cnwl.nhs.uk
© Central and North West London NHS Foundation Trust, August 2012