Orchard Beds Vindicated by The Freedom of Information Requests

Today Beds in the Orchard received the responses to the FOI requests.

All along, we have said that the closure of the ward was for financial reasons, that it was due to impact of closing the 22 male beds in Burnley and that it was until The Harbour opened.  The Trust have denied this.

They have denied this on BBC Radio, in the Lancaster Guardian, to our service users in response to our letter of complaint and in the letters to the MPs.  Below are some of the things that have been said.

• "The intention isn't for this to run for weeks and weeks".
• "I would like to reassure you that the use of The Orchard as an all-male facility is very much a temporary measure."
• "This isn't for financial reasons."
• "This has nothing to do with the closure of the ward in Burnley."

To reiterate:-

This was a short term, temporary measure that wasn't for financial reasons and had nothing to do with the closure of 22 beds in Burnley.

The FOI information should have backed this up.  The Trust have been consistent in their reply and surely they would not give misleading information to the media, their service users or the MPs would they?

Perhaps we're misunderstanding what we've been sent, but here is some of the information provided to us from our FOI requests.

From 9/9/14 Sustainability Minutes - Suggestion made to open male ward on Darwen as no extra staff will be required. Discussed use of the Orchard as a ‘flexible friend’ to support longer term pressures of gender demand and we could scale down females to make all male to support this transition.

Longer term pressures of gender demand.  Please note: Longer term pressures.  Not short term pressures. Making the ward all male for longer term pressures.


Many thanks for your input and pragmatism yesterday in the meeting around managing the correct number of male vs female bed reductions, in line with our need to close a ward in total this financial year.

Our need to close a ward in this financial year.  Please note: Close in financial year, for financial reasons.


We all agreed we couldn’t manage with the loss of 22 male beds though so we agreed mitigation plans (some dates for the mitigation actions below TBC):

We couldn't manage with the loss of 22 male beds.  Please note: The closure of the 22 male beds in Burnley was acknowledged as unmanageable and therefore would have a known impact on the rest of the inpatient provision provided by the Trust.


TH suggested using The Orchard as a flexible ward if the network is under pressure for male or female beds for a period of time. The current female patients could be moved to Scarisbrick Unit. AW stated that as the Orchard is a standalone unit it would have to be clear which patients could be admitted as there is only 1 seclusion room. The ward would be flexible until the opening of the Harbour.

Flexible until the opening of the Harbour.  Please note: Until the opening of The Harbour.  The hospital due to open in March 15 if it runs to time. 

There are other details in the FOI information, mainly talking about where they were going to make up the shortfall of beds, and talk of the transitional period - which we believe to be the period before the beds being closed and The Harbour opening.


What is clear is that what we said all along was true.  That the women of North Lancashire were the victims of cost cutting measures and the closure of the Male ward in Burnley and that the Closure of the ward was until The Harbour opened.

Shame on you Lancashire Care NHS Trust.  Shame on you for treating your female service users like this.

Full response publicly available here.

Our response to the Trust's email to our lovely MP

There's a few things that bother us about the Trust's reply to David Morris's email.

We can summarise quickly as follows:

This temporary measure has been in place for a month and during this time, approximately 6 females from the North Lancashire area have been admitted to a Trust facility in the wider Lancashire locality.

6 Women sent out of area and 6 missing beds.  Neat.  Also...approximately?

"A campaign group has been started called “Beds In The Orchard” which describes itself as “a campaign for the reinstatement of female psychiatric inpatient provision at The Orchard hospital in Lancaster”. The group are tweeting from the handle @OrchardBeds and, amongst other things, are encouraging people to contact their MP."

Yes, that's us and contacting your MP is a perfectly reasonable course of action to take when one group of vulnerable people, in this case women, are sent out of the area to accommodate another group of vulnerable people, in this case men.


"It is important to note that the Trust provides beds on a pan Lancashire basis."

But apparently closing 22 male beds elsewhere in the county wouldn't impact on the need to provide additional capacity for men elsewhere.  OK?

"Demand for female beds can often rise in the spring time. In order to respond to these fluctuations, the Trust’s inpatient services have been designed so that the ratio of male and female beds can be flexed to respond to meet demand accordingly."

When there was the upswing in female referrals earlier this year, the Trust did not close the whole of one facility to men to cope with that demand.  Women were sent to The Priory in Manchester.

"The Orchard and the Trust’s other inpatient facilities have the flexibility to respond to an increase in female activity too. The Trust’s new facilities have been designed with this in mind and feature ‘swing beds’ so that the ratio of male/female beds can be altered in line with demand which is a dynamic situation."

The facilities haven't been "flexed" they have been closed completely.  

Views of a worker in the Lancashire Care NHS Trust

I cannot thank enough the writer of this piece.  Our campaign has been noticed by people who work in the trust and one person has been kind enough to share their thoughts.  For good reason they wished to remain anonymous and as such we don't have details for them.  We have mailed our heartfelt thanks to them for sending this to us tonight.

I am greatly troubled and saddened by the closure of The Orchard Psychiatric Unit to women in Lancashire, whether permanent or temporary.  I am incensed that this was executed without patient and carer consultation, but I am in no way surprised.

The word is that this is temporary until The Harbour the new 'flagship' hospital opens next year, yet amazingly there was no need to stop women's access to the Orchard because until a few weeks ago a full male ward of around 22 beds, was open and fully functioning; Ward 18 in Burnley General Hospital. This should have remained open until the 'Harbour' was open to accept this extra population of patients.

The reason for this process can only be financial.

As a worker within this same Trust, I see the effects upon patients, their carers, families, friends and wider social networks of certain Trust policies.  However; we must remember that Trust Executives and Governors are duty bound to tow the line set by the Department of Health, and this Government.

In other words the Trust Board, it's Governors and high tier management are generally formulating policies which in essence look purely at apparent immediate and short term financial reductions not normally genuine economic benefit.

I have to question where the Duty of Care has disappeared for both Trust Board members and the Department of Health. The government quite rightly espouses duty of care, but acts like it has no duty of care where short term finance is concerned. I believe Stafford was also partly a result of 'Target' driven management which seriously affected staff morale.

Government and Trust policies often ignore true patient need; i.e. an excellent package of care, looking specifically at an actual in depth holistic assessment of the patients and families therapeutic needs; followed by a full and rigorous provision of the identified therapeutic needs with fully trained staff at all levels.

I wonder whether people are aware that just 3 or 4 years back, the Trust initiated it's DoH ordered programme of budget cuts by a fifth (20%).   Within the last year I was advised that this figure was increased to a quarter (25%). This programme had a 5 year time period. 

What this means in real term reductions, someone smarter than I will have to say. These cuts march on, contrary to the statement earlier this year by David Cameron that NHS budgets are safe and 'Ring fenced'.

It should also be noted that in the midst of this earlier 20% cut, the board approved and the Chief Executive accepted a 20% RISE in her salary. This took her already incredible salary way over £200,000.  In my opinion, if someone needs such a salary as an inducement to stay in post, I have to ask; does that person have the right motive to be there?

Surely providing what is NEEDED has to be the MOST economical way of caring for a person who is ill. I believe especially so with mental illness. With physical brain lesions, we expect everything to be thrown at brain Surgery; e.g. if a family member has a brain tumour or has been involved in a fall; yet we give as little as possible towards brain manipulation (Psychiatry / Psychology), where the affect is functional. This is the same organ.

I feel duty bound to loudly state that providing the necessary holistic and comprehensive person centred care package is an imperative for all patients, their families/carers and the wider socio-economic setting.  Common sense says that this care package has to include ready access to a LOCAL inpatient unit when hospitalisation is necessary.

People with Mental Illness are so often sidelined, minimalised and misunderstood even by their own family.  Not to mention their friends, fellow colleagues, Workplace Management, and dare I say it, yes even a number of so called Mental Health 'Professionals'. This ignorance affects their attitude and therefore behaviour towards the person with the illness, and results in the knock on effect of increased interpersonal stress which can only exacerbate the symptoms of the 'Broken Mind'.

If we break our leg, we put the utmost care into protecting it. We talk with empathy and treat the person suffering with compassion. We put a rigid cast on the injury site. We provide crutches to allow the person to support their leg whilst walking, or a wheel chair if things are more complicated; and we all rally around to help, even wanting to push the wheelchair.

However, with a fracture or a break in the mind, we act as though the mind does not require this protection. It's uncomfortable for us so we say- get a grip, pull yourself together, your just behaving badly. We are full of negative clichés. Yet, trust me, I know from experience that a person CANNOT just do these things without the 'appropriate' support and time.

With mental illness a 'glitch' has occurred in the brain's development or programming; or neurones are not communicating as and when they should. It is probably short term, but it WILL be longer term without the appropriate Stress free help; but this will likely develop into a permanent illness for many if we stay on the road we are on.  Would you wash a burn site with hot water? No,; likewise you should not add stress to a broken mind.

My own family have suffered greatly due to mental illness and we are still affected many years on.  When a member of your family is in a hospital away from home and you have to travel far to see them, it impacts greatly on the family all in areas such as emotion and finance. 

Mental illness impacts on the economy, with time taken off work and adds extra pressure on Health Services and staff.  Proper mental health care will have financial benefit across the national economy, including maximised productivity in the individual’s workplace.

As is the need of all, give these women all that they need to recover close to their homes, and the costs will be as low as it is possible to be.  Holistic and appropriate care should be the Government and Trust values, not back room cuts and decisions for financial, not caring reasons.

Remember, it may be your Mother, Wife or Sister who has a sudden breakdown soon.

                                                                           

For those of you who don't twitter - Our take on the response from Lancashire Care

The Beds in the Orchard Campaign received its first official response from the Trust this afternoon via our Twitter account @OrchardBeds from @LancashireCare.

Here's what they had to say and, of course, our response.

@OrchardBeds The decision to operate male only beds at The Orchard is a temporary measure and is under constant review. (1/5)

We can't argue about whether or not this is true as we only have this statement from the Trust about it.  However; we do know that some Trust staff have been advised The Orchard may revert back to mixed provision once The Harbour opens in March 2015, suggesting that it is not under constant review as the decision has already been made.  We are open to concede there may have been a communication problem if staff have not been informed about it remaining male only until the opening of The Harbour.

Regardless of whether this is temporary or not, it is impacting women and families now.  It is hurting female service users now and there remains no clinical benefit to women from the closure.

@OrchardBeds There is a peak in demand for male beds & a reduction in demand for female beds - we have empty female beds at present. (2/5)

Two responses here.  Firstly, it is likely that the peak in demand for male beds is linked to the trust closing a 15 bed male ward in Burnley and it is rather disingenuous to cite demand for male beds being the driving factor after closing 15 of them.

Secondly, the point about empty female beds is slightly misleading.  The status of beds can change on an hourly basis.  From personal experience a bed can be taken in the time it takes to have a consultation with your psychiatrist about whether you should go into hospital or not.  A freedom of information request has already been submitted to the trust about how many women they've sent out of area in the last 4 years, often to private hospitals that should clarify demand.

We also directed them to this post - http://bedsintheorchard.blogspot.co.uk/2014/10/is-based-on-need-self-fulfilling.html

This isn't about empty beds.  Its about denying a whole group of service users access to local inpatient care solely based on their sex.

@OrchardBeds All Trust facilities have the ability to flex male/female beds in line with demand. (3/5)

This is indeed True.  The Orchard had two 'swing' beds that could change between male and female.  There were 10 fixed male beds and 6 fixed female beds.  Up until recently, the two swing beds were female.  The trust could have swung those beds to male, giving them 12 male and 6 female beds at The Orchard. Instead they decided to deny access to a whole group of service users from a wide area. 

It is rather disappointing that the Trust sees removing access to local inpatient care to all women in the Lancaster area as 'flexing'.

@OrchardBeds The Orchard will revert to mixed sex as soon as this is clinically appropriate. (4/5)

There's nothing we can really say about this other than, how is it clinically appropriate to deny women access to local inpatient care.  No, seriously.  Our twitter handler has replied that we will be happy to discuss this with someone qualified to explain the clinical benefits to women of sending them out of the area for treatment.

 @OrchardBeds We would be happy to discuss this further with you and you can contact us on communications@lancashirecare.nhs.uk (5/5)

One of our team had already emailed the complaints department with the letter we published here

http://bedsintheorchard.blogspot.co.uk/2014/11/not-sure-what-to-write-when-you-complain.html

We will publish their response as soon as they receive it.