Tier 4 Personality Disorders Joint Scrutiny Committee

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Tier 4 Personality Disorders Joint Scrutiny Committee

Post  Karl on Wed Oct 28, 2009 2:11 pm

This can also be read by clicking the link below

Diary of a Sutton Councillor


Tier 4 Personality Disorders Joint Scrutiny Committee

This joint committee had been set up in response to the proposed closure of the Henderson Hospital in Sutton which provided a specialist residential treatment programme for people with complex and severe personality disorder. People with this kind of personality disorder fall within the Tier 4 level of service provided by the mental health service.

This level is highly specialised with treatment provided to a small number of users from a large geographical area, covered by 62 Primary Care Trusts. Because of this degree of specialisation the service was overseen by a Joint Commissioning Group headed up by Jo Scott Associate Director South East Coast Specialised Commissioning Group. The inpatient treatment at the Henderson was one of a range of treatments able to be offered at Tier 4 level and was a unique option at this level.

As the result of a number of Local Authorities in the areas covered by the 62 Primary Care Trusts agreeing that the closure of the Henderson represented a significant variation of service the Joint Commissioning Group was legally obliged to consult on the change.

The role of our Joint Scrutiny Committee tonight, chaired by myself as the Henderson Hospital was located in Sutton, was to review the consultation to determine whether it was conducted in an satisfactory fashion, and to consider whether the proposals agreed by the Joint Primary Care Trust Board following the consultation would be in the best interests of our residents as potential service users. Representing other Local Authorities who had expressed concerns over the impact of the closure of the Henderson Hospital were Councillor Alex Jacob from London Borough of Wandsworth and Councillor Sheila Knight from London Borough of Merton.

The committee had received an independent summary of the consultation results and we had been kept well informed of progress throughout the consultation period.

Brief presentations and information on the consultation process were provided by Jo Scott Associate Director South East Coast Specialised Commissioning Group; Dr Diana Menzies Consultant Psychiatrist in Psychotherapy (previously at the Henderson) and Kath Lovell of the London Personality Disorder User Network. Both Dr Menzies and Ms Lovell had been closely involved with the consultation process as members of the Consultation Advisory Group.

Also present were representatives of an ex-Henderson service users group. There was inclusive discussion about the consultation and generally satisfaction with the process and its inclusiveness were expressed.

Dr Menzies and Ms Lovell expressed concern about the expansion of the consultation to Tier 4 services rather than just being about the Henderson, and the fact that the results of the consultation went no way towards safeguarding the Henderson model due to its broad scope.

The committee also took evidence from Eric Karas Head of Psychological Therapies Barnet, Enfield and Haringey Mental Health Trust and Professor Anthony Bateman, a specialist in the field of personality disorders. Mr Karas and Professor Bateman expressed concern about the narrowness of the proposed models used in the consultation and felt that insufficient consideration had been given to alternative treatment models. Professor Bateman gave a short presentation setting out an alternative service specification. It was established from questions that the Joint Commissioning Group had not gone outside of their area to consult with other professionals in the field such as Professor Bateman.

Jo Scott advised that the consultation summary had been circulated to all 62 Primary Care Trusts requesting their recommendations and these would be collated and a final proposal put to the Joint Primary Care Trust Board on 11th November. As most of the Primary Care Trusts had yet to reply she was unable to say as yet what the final proposal would be. The committee requested to view the final proposal and have an opportunity to comment on it before it went to the Joint PCT board. This was agreed.

The committee also requested updates on progress on the implementation of the final proposal and agreed to meet again in one year.

In the meantime the committee would prepare a letter for the Joint Commissioning Board with its conclusions from this meeting.

Karl
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