Plan for modernising mental health services approved by NHS Western Isles

A plan that details the steps to be taken to develop an enhanced community mental health service in the Western Isles has been approved by Western Isles Health Board.

The ‘Implementation Plan’ describes the work that is required to transform mental health services from what is currently a hospital focused model of care to a person centred, ‘recovery’ model of service provision, closer to people’s homes and communities.

This process will take place in stages.

NHS Western Isles Medical Director, Angus McKellar, described the principle behind the change as ‘more care going to the patient, rather than the patient having to go to the provider’.

This approach was welcomed by Board members at the Board Meeting on October 29th.

Whilst there will be more of a focus on enhancing community services, there will continue to be inpatient beds available when admission is required.

The enhanced community model was selected as the preferred option after a public consultation across the Western Isles last year.

The case for changing the configuration of mental health services is based on an understanding that the way services are currently set up in the Western Isles does not allow for an effective, locally delivered approach to mental health service provision.

NHS Western Isles Nurse Director, Sandy Brown, explained: “Our mental health staff deliver excellent care within the current model, but the configuration is completely imbalanced, as 95 per cent of our patients are based in the community; and between 85 and 90 per cent of our resources are in the hospital.

“To deliver the care that patients need, it’s important that we address this imbalance and invest in community services.”

The enhanced community model maintains inpatient capacity within Western Isles Hospital, though on a smaller scale.

Care will be provided by a single team of practitioners (rather than two teams as at present), allowing for the redeployment of a significant number of staff into community teams, providing care where it is needed most; in the communities of the Western Isles where our communities live.

The plan is to develop distinct ‘zones’ within a single mental health inpatient unit and the patients would be cared for by a single team. This would be an innovative and groundbreaking model in terms of mental health services in Scotland.

In terms of community services, there will be two community teams; one covering Lewis and Harris and the other covering the Uists and Barra.

The teams, which will require financial investment and training, will be very closely linked with GP Practices. Teams will have a range of skills, so that a variety of mental health issues can be managed safely and effectively in the community, helping to prevent inappropriate hospital admission.

Work will be taken forward by five different workstreams, directed by a Project Team, reporting to a Project Board.

The Environmental Group will develop a clinical brief to enable architects to redesign the inpatient environment, bringing together the two wards, so that teams and skills can be brought together.

The Workforce Group will consider training/skill enhancement requirements, working with existing staff to identify and match staff to new roles.

The Collaborative Partnership Group will work to ensure there is joined up working between NHS Western Isles and other partners, including the voluntary sector.

The Service Model Group will define the new mental health model in detail.

The Policy Group will review and development policies and procedures as necessary to support the new model.

There will be updates on specific aspects of the project at every public Board Meeting.

The Modernisation of Mental Health Services Implementation Plan is available: here