Consultation on Proposed Changes to Humber Mental Health


Humber Mental Health Teaching NHS Trust provides services for people affected by mental health, learning disability and addictions in the city of Hull and East Riding of Yorkshire.

Our aims are to:
“Promote, Maintain and restore Mental Health and Wellbeing”. Although we work closely with and often in partnership with the East Riding of Yorkshire Primary Care Trust, the services described within this consultation document are quite separate from the ones that were recently described in the East Riding of Yorkshire Primary Care Trust consultation exercise which included the future of local hospitals.

This consultation solely focuses on the modernisation of community and hospital based mental health and learning disability services within the East Yorkshire area and how they will be provided over the next few years to improve the patient and carer experience. The way that mental health services in England are delivered has changed quite significantly over the past few years. Services have moved away from hospital based institutional care to community based packages which reflect the patients individual need.

In the East Yorkshire area, Humber Mental Health Teaching NHS Trust, with the support of the East Riding of Yorkshire Primary Care Trust and the East Riding of Yorkshire Council are planning to modernise the mental health and learning disability services provided in the area, to ensure that the residents of East Yorkshire receive an equitable, modern and effective mental health service which meets their needs. The design of this whole systems review for mental health services in the East Riding of Yorkshire area has been greatly influenced by a publication called the “10 High Impact Changes for Mental Health Services” developed by Care Services Improvement Partnership (CSIP/NIMHE – 2006).

This document aims to share practices in mental health services and spread learning about what has worked for people in other areas of the country.

Ten areas of service improvement in mental health services have been identified that will have the greatest positive impact for service users and carers.

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It highlights the following principles that should be included in the design of any service

  • People should have their mental health services provided at home whenever possible
  • There should be joint health and social care assessments to avoid duplication
  • All people who use mental health services should have the same experiences in:
    - accessing services,
    - assessment of need,
    - provision of treatments and
    - discharge from services
  • Whatever their mental health problem and wherever they live.
  • Services should be based on what is known to be effective practice
  • People using mental health services and their carers should be given information to enable them to be fully involved in their care


Elements of this proposed model of service provision is one that has been developed through discussion with other mental health providers and user and carer stakeholders over the past 3 – 4 years.

The purpose of this consultation is to:

Inform people who use mental health and learning disability services in the East Yorkshire area of the proposed changes that will occur

  • Let carers know how the proposed developments to services will effect the person they care for
  • Share the plans to modernise the services with other stakeholders in mental health care
  • Gather the views of individuals and groups who represent the user/ carer voice in mental health services in the East Riding area.

It is envisaged that the changes that will occur to services in the East Riding of Yorkshire will take place over a period of 2 years.

Management of Services

Services are currently managed in teams that reflect the group that services are being provided to ie adult mental health, older peoples mental health and learning disabilities.

We plan to bring the current services together under a locality type model, which will fit with social care services and Primary Care Trust management arrangements. Each service will be managed through a single locality manager for mental health services. Clinical staff will retain and build on their
skills and expertise.

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The proposed model will also change the way that people access services. In the traditional model there were at least 4 entry points, where people could access mental health or learning disability services in each locality. The new model will reduce this to one, which should ensure less confusion for referrers and a smoother passage for people who have been referred into assessment
and treatment.

We believe that these changes will enable us to reduce our current management costs and will allow us to utilise our staff and buildings more effectively.

Learning Disability Services

Learning Disability Services will be essentially unchanged by the reorganisation. The member of staff who provides the face to face care may be based somewhere else, but the majority of client care is delivered within the client's home or another community setting. Where someone needs hospital admission to a learning disability setting, this will still be accessed through Townend Court on Cottingham Road in Hull.

There will be no change to the support that the Trust offers to people who live within the accommodation provided by the Spice Trust across the East Riding of Yorkshire area. It is also planned to improve the services ability to support people with a learning disability within their own homes etc, with an increase in the home treatment availability across the East Yorkshire area.

Older Peoples Mental Health Service

Community staff may be based in a different location to where they currently are, but will continue to provide most services within the client's home or other community setting. When an in-patient admission is necessary, instead of this taking place, as it does now at either Castle Hill Hospital or Bridlington and District Hospital, we are currently negotiating the availability of 13 beds within a new fit for purpose unit presently being built by the East Yorkshire of Riding Council on Walkergate in Beverley.

For residents of the Holderness area, Maister Lodge in East Hull will continue to provide the older peoples in-patient service.

Currently our in-patient services have many vacancies, for instance Waters
Ward at Bridlington District Hospital in 2005/6 had on average only 4 of its 10 beds occupied at any one time. Rivers Ward at Goole and District Hospital is currently closed due to long term occupancy figures of between 10% and 20%. Clients from Goole who need in-patient services are currently receiving them on the Mill View Lodge site at Castle Hill.

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The public consultation conducted throughout the Autumn of 2006 centred around the principles of reducing 3 in-patient units to one central facility and to enhance the community teams and provide services outside of traditional Monday to Friday 9am – 5pm hours.

The consultation achieved support for the principles with Rivers Ward at Goole subsequently closing.
In the proposed new model we plan to utilise a number of the staff who provide in-patient care in the same way ie to provide an intensive home support service across the whole East Riding of Yorkshire area served by Humber Mental Health Teaching NHS Trust.

Adult Mental Health Services
As for older peoples mental health services and learning disabilities services our plan is to locate and manage our community adult mental health services within the locality model already described. We intend to increase the availability of Crisis Resolution Services and introduce intensive home treatment across the whole of the East Yorkshire area which will mean that more people can be successfully cared for within their own homes and communities.

The model proposed will mean significant changes to in-patient services.

Adult Hospital Provision
Current Proposed
Mill View Court – 10 beds Remains the same
Mill View Lodge – currently 10 beds for older people
Client group changes becomes 8 beds for adult hospital care.
Older peoples in-patient care transferred to new build in Beverley - 13 beds
Buckrose Ward – Bridlington (12 beds)
Bartholomew House - Goole (10 beds)
Review of use of beds and consultation to take place regarding future provision. One unit to close dependant on outcome. Beds from closed unit will be reprovided within Mill View Court/Lodge development.

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Older Peoples Hospital Provision
Current Proposed
Waters Ward – Bridlington (10 beds) Closes.
Older people's in-patient care transferred to new build in Beverley - 13 beds.
Mill View Lodge – Castle Hill Hospital site (8 beds)
8 beds transfer to adult in-patient services
Older peoples in-patient care transferred to new build in Beverley - 13 beds.

We are currently undertaking a consultation exercise commencing on 2 April 2007 and completing on 25 June 2007. During this period we intend to talk to as many people as possible, informing them of our plans to modernise and improve mental health services for the people of the East Riding of Yorkshire area. If you have any queries regarding this could you please contact [email protected] or 01482 303966.

Humber Mental Health Teaching NHS Trust would be grateful to receive your comments. You can write to us at East Yorks Whole Systems, c/o Patient Experience Team, Humber Mental Health Teaching NHS Trust Headquarters, Willerby Hill, Beverley Road, Willerby, HU10 6ED or you can e-mail us at
[email protected]

You may want to give your views on the new model of providing mental health services through an independent group. The Humber Mental Health NHS Patient and Public Involvement Forum have agreed to act as a co-ordinator of these views and can be contacted on 01482 472458 or by writing to the
Humber PPI Forum, Titus Salt House, Newland, Cottingham Road, Hull, HU6 7RJ.

As the consultation period progresses, the Trust will post a “commonly asked questions” page on its intranet site with the Trust's response to these. We will update this on a 2 weekly basis. We will publish a summary of the responses on the Humber Mental Health NHS Teaching Trust internet site www.humber.nhs.uk and the HEROS web site run by the North Bank Forum www.heros.org.uk as soon as possible following 25 June 2007.

1 Consultation on the Proposals to Improve Mental Health Services in Hull.

The way that mental health services are provided in England has been changing considerably since 2000. The Department of Health has required Trusts to modernise mental health services. They have provided us with specific guidance on how to do this.

The guidance and direction is based on:

  • Current research into the best way of providing mental health care
  • Good practice examples from other countries and areas of Britain
  • Views, experiences and expectations of what a modern mental health service should provide.

In the last 5 years Humber Mental Health Teaching NHS Trust and Hull City Council Social Services have developed a strong partnership to improve the way that community mental health services are provided to the residents of Hull.

This partnership has already seen the successful development of new services such as a city wide assertive outreach team, PSYPHER and a Crisis Resolution and Home Treatment Team (see definitions of these services at the end of this document), which have enabled more people to receive their care and treatment at home instead of in a psychiatric hospital setting. None of these services are to be changed. The partnership is now at the stage where it needs to reorganise how the“traditional“ mental health services such as Community Mental Health Teams and in-patient units work. We also have support and encouragement for the new model of care from the Primary Care Trust in Hull, who commission or“buy” mental health services in the Hull area.

We are now at a point where we are ready to share our plans by describing:

  • what the new way of delivering our service will look like
  • how it will affect the individual person, who is a current patient or a carer of someone who uses mental health services in Hull.

Hospital Service
The new model will mean that if people need to come into hospital they will initially go to the Assessment Unit (Avondale, which is based next to the Hull Royal Infirmary site on Anlaby Road in Hull). The Assessment Unit Team will work very closely with the Crisis Resolution Home Treatment Team to ensure that they help and support people to go home as soon as possible. This will 2 involve looking at all the factors that are making it difficult for a person to cope with their mental health problems and providing whatever support, intervention and treatment they can to help alleviate them quickly.

If the Crisis Resolution Home Treatment Team and the Assessment Unit Team feel that someone is likely to need help/treatment and support in hospital for longer than 7 days then they will be transferred to one of the treatment units (Westlands for people who reside in West, North or Central Hull or Newbridges for people who reside in East Hull). Each of the treatment unit teams will work closely with the person to develop a plan to improve their immediate distress or symptoms and help them to cope with their mental health problems with the right level of support and intervention. They will work closely with the locality community teams to develop the right package of care once they go home.

Community Mental Health Services
We currently have our community mental health staff in 5 different bases across the Hull area. These teams have an overall responsibility for delivering care within a geographical area. These teams currently meet all the assessment treatment and care needs of people who are of working age.
These teams will be replaced by:

  • One assessment team which will work across the whole city and will provide specialist skills in assessment of mental health problems and work with people on a short term basis to help resolve any mental health difficulties.
  • Three geographically based teams (East, North/West, Central) which will provide longer term intervention aimed at supporting people with more serious mental health problems and assisting with their recovery.

Humber Mental Health Teaching NHS Trust and its partners from Hull City Council Social Services plan to move towards the new model of service from the 25 June 2007

What will this mean to me?
The impact of these changes will affect most people who are currently using the services to some degree
The change could be:

  • Change of Care Co-ordinator
  • Change of Psychiatrist
  • Change in the venue that you see your mental health worker

Your present Care Co-ordinator will discuss with you what the changes will mean for you personally.

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Your Care Co-ordinator will also discuss with you any anxieties/difficulties you have regarding the changes. We would like to receive your views and comments on our new model, especially regarding the following areas:

  • How will we know if the new service is working well?
  • How can we help people through the changes with as little disruption as possible?
  • What questions do we need to ask people to help us understand what they need from a modern mental health service?

We are currently organising a consultation process which will start on 2 April 2007 and finish on the 25 June 2007. During this period we intend to talk to as many people as possible, to inform them of our plans to modernise and improve mental health services for the people of the Hull area. If you have
any queries regarding this could you please contact [email protected] or 01482 303966, available outside of Monday to Friday on answer-phone.

Humber Mental Health NHS Teaching Trust would be grateful to receive your comments. You can write to us at Hull Whole Systems, c/o Patient Experience Team, Humber Mental Health Trust Headquarters, Willerby Hill, Willerby, HU10 6ED or you can e-mail us at [email protected]

You may want to give your views on the new model of providing mental health services through an independent group. The Humber Mental Health NHS Patient and Public Involvement Forum have agreed to act as a co-ordinator of these views and can be contacted on 01482 472458 or by writing to the
Humber PPI Forum, Titus Salt House, Newland, Cottingham Road, Hull, HU6 7RJ.

We will publish a summary of the responses on the Humber Mental Health Teaching NHS Trust internet site www.humber.nhs.uk and the HEROS web site run by the North Bank Forum www.heros.org.uk as soon as possible following the 25 June 2007.

Terms used within this document

Crisis Resolution
Previously, the only option for most people needing urgent mental health care was admission to hospital. Often this resulted in a long period away from home, work and social networks and could mean that all of these are damaged or lost. Specialist Crisis Resolution Teams make an urgent visit to
anyone who is thought to need to go into hospital. Often, the crisis can then be resolved and, by providing intensive treatment at home, a great many hospital admissions can be avoided. This type of service is one that many people state they prefer.

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Home Treatment
These teams provide intensive treatment and support in the home to individuals and the people around them when they are experiencing a severe mental health problem or difficulty. By helping individuals manage and resolve their crisis through home treatment as an alternative to hospital admission, this helps to minimise disruption to their lives.

PSYPHER (Psychosis Service for Young People in Hull and East Riding). Some serious mental health difficulties, such as schizophrenia, usually first occur during teenage years or the early twenties. Often young people will be unwell for six months or more before they get any help. To remedy this unacceptable situation, early intervention teams will be able to provide the intensive support and help that every young person who develops a first episode of psychosis needs. These teams operate in ways that young people can relate to, providing help and advice on managing symptoms, and will base their care on the belief that engagement, rather than compulsion, is the key to success.

Assertive Outreach
A small number of people use a lot of mental health services. They are frequently admitted to hospital, often compulsorily, but sometimes lose touch with services soon after discharge. Often they suffer from a dual diagnosis of substance misuse and serious mental illness. For this group, Assertive Outreach teams providing intensive support at home can keep in touch with them, reduce the amount of time they spend in hospital, and help the people using the service to enjoy a better quality of life.

Community Teams
Community Mental Health Teams (CMHTs) will continue to have an important role to play in supporting service users and families in community settings. They provide the core around which modern mental health services are developed. Working with primary care, they are the main pathway for referrals to the more specialist teams. CMHTs will also continue to care for the majority of people with severe mental illness in the community.

In-Patient Care
In-patient units (hospitals) will continue to play an important part in local mental health care. An effective support system must get the balance right, between better community-based care and high quality, therapeutic in-patient care in good accommodation. These proposals will ensure we provide good
standards of dignity and privacy for hospital clients and safe hospital facilities for clients who are mentally unwell.

Definitions taken from
“A Journey to Recovery”,
The Governments vision for mental health care, (Department of Health 2001)

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