Three options to modernise mental health services in the Western Isles have been presented to Western Isles Health Board.
Option 1 proposes no change to the current service, option 2 focuses on maintaining people within the community with no local inpatient service, and option 3 proposes an investment in community services and partially disinvesting in inpatient services.
Option 1 is considered to be an outdated model of service, with an emphasis on admission, and resources concentrated around the inpatient facility in Western Isles Hospital. Evidence suggests that this creates a culture of dependency, and it also goes against how staff, service users and partners have said they wanted to see services delivered.
Options 2 and 3 both offer the possibility to transfer staff into the community and also to consider resource transfer, if appropriate, to partner agencies.
Option 2 would result in increased community capacity, but would also mean that acutely ill patients would have to travel to the mainland to access inpatient facilities.
Option 3, which is based on the recommendations in previous mental health reports would increase capacity in the community - ‘shifting the balance of care’ - whilst retaining an inpatient facility for acutely ill patients.
The options were developed as a result of extensive consultation exercises through the Clinical Strategy process over the past four years, as well as through the Clisham Project and Watt Report.
The Board agreed that a formal option appraisal process should now take place within the next two months, with the involvement of key stakeholders.
This will enable members of the public, staff and other agencies to get involved in considering the pros and cons of the three options, to put forward other potential ideas for consideration and to potentially determine a preferred option for recommendation to Western Isles Health Board.
NHS Western Isles Medical Director Dr Jim Ward explained: “NHS Western Isles is focused on the strategic development of services for people with mental health problems, and providing local support within the community to reduce the likelihood of individuals requiring inpatient care. What is also fundamental to any considerations is that, where inpatient care is required, it must be provided in appropriate surroundings.”
The modernisation of mental health services was identified as one of the Board’s three key priorities for service redesign in 2010.
Since then, work has progressed through a strategic group chaired by the Board’s Medical Director, with a number of engagement meetings held to ensure that the areas identified in earlier consultation meetings remained current thinking. Consultation and engagement with key stakeholders will continue and a further paper will be presented to the Board after the option appraisal has been completed.