Recently LYPFT lost the tender for most of the mental health services in York to Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV). At around the same time Bootham hospital, York was forced to close by the CQC. Here is a timeline of what I have found and what I plan to ask at the next LYPFT meeting.
Summary of Patient-led assessments of the care environment (PLACE)
Changed to foundation trust – LPNFT
Acquired York services and changed to LYPFT, The LYPFT 5 year strategy was refreshed in 2012.
Started apprentice scheme.
Care Quality Commission (CQC) identified problems at Bootham Park Hospital.
Opened new women’s low-secure unit in York.
September 2014 meeting
’…the quality of the estate in York was a concern to the trust and the Care Quality Commission reinforced the Trust’s view that the inpatient wards at Bootham Park Hospital and Lime Trees are not suitable for modern-day inpatient care. However …NHS Property Services Ltd, who owns the York Estate, has agreed to refurbish Mill Lodge as a new impatient unite for those service currently at Lime Trees…… reported that the Vale of York Clinical Commissioning Group as also agreed to refurbish Cherry Tree House and Bootham Park Hospital so that better inpatient wards would be provided to adult patients on an interim basis whilst longer term plans for a new hospital to be built for the people of York are progressed. ‘
A member of York Mental Forum ‘raised a question about the future plans for Bootham Park Hospital. In response it was noted that the Trust was of the view that although it was difficult, it was not impossible to provide 21st century inpatient services out of an 18th century building…….there was two stages: the first being plans to conduct interim work associated with making further improvements to the environment in Bootham Park Hospital and noted the changes that were proposed to the locations of the individual services. ……… assured members that the Trust was working with partners in York to ensure bespoke mental health services were available to service users.’
Annual report March 2015
-‘Work has been undertaken to review the future of Bootham Park Hospital whilst focusing on short-term environmental improvements.’
-Higher % of York population has used IAPT services and LYPFT has reduced time from referral to assessment.
-CAMHS relocated to Mill Lodge for a ‘better environment’
-York Inpatient dementia services changed into single-sex units.-One of 10 possible risks to LYPFT was “Continuing to provide services from premises of which the trust is not in direct control that have been identified as not suitable from an environmental perspective’
-Established volunteer run info and drop-in centre at Bootham Hospital.
-LYPFT hoped to have a fixed home for new York hub teams. Hoped to have a solution by working with York CCG & NHS Property Services by the end of September 2015!
‘Much work has been undertaken to review the future of Bootham Park Hospital. We understand and recognise the importance of Bootham Park to the delivery of inpatient and community care in York….We have completed work to eliminate ligature risks from the fabric of the building and have completed a review of the security of the building, meaning service users can expect to receive safe care. Our long term plan continues to be to provide inpatient services from new facilities which will be fit-for-purpose and allow delivery of modern health care.’
April 2015 Meeting
-It again noted that the estates in York were not owned by LYPFT.
-Slightly worse 7 day-follow-ups in York compared to Leeds.
-Noted vacancies unfilled across LYPFT, nationally this is also allegedly a problem. Bootham Ward 6 was experiencing higher levels of sickness.
LYPFT learnt is was not the preferred bidder for York CCG mental health services.
..an update to the Board on the latest position in relation to the timelines and delivery of the Bootham Park Hospital interim estates solution. ….advised the Board the slippage on the project noting that this has now been formally advised to the Trust by NHS Property Services Ltd and that the expected completion date was November which is beyond the timeframe agreed with the CQC in respect of the compliance action. …. Noted that the CQC had been formally advised of the slippage…. updated the Board on the conversation which had taken place with the CQC noting that they had formally requested details of the slippage, which had been supplied, and that a response was still awaited from them…… acknowledged that the matter was in the hands of NHS Property Services but asked what the trust had done to escalate this matter and ensure that the project is delivered on time, noting that XXX had suggested this be done in October 2014….noted that the matter of the risks in relation to the environment at Bootham Park Hospital was formally identified by the CQC during their initial inspection late 2013, and indicated that in their view the Trust had done all it could to ensure the environment was as safe as possible and the Trust had through its membership of the Bootham Programme Board, done all it could to influence the progress of works…….. assured the Board that everything within the power of the Trust had been done to ensure the matter is expedited and that there is a clear audit trail of the Trust’s input. XXX acknowledged all this work, but felt that the Trust’s concerns could have been better progressed through the Chair or Chief Executive and that in his view there could be insufficient evidence of the Trust raising concerns at a very senior level about the delays. ….noted that the CQC is aware that the resolution of this matter is not in the hands of the Trust. …. Also noted that when XXX had first suggested that the matter be escalated a judgement was made that the Trust was building better relationships with NHS Property Services and the Vale of York CCD locally and that escalating the matter could be detrimental to this progress at that time.’
July 2015 Meeting
-Update on York improvements. There was a demand for extra psychological services in York. But in York services are allegedly commissioned separately by York CCG. Less money is spent nationally in York per head of population than Leeds.
-Meeting was told that LYPFT bid had been slightly higher in quality but lower on finances. But overall the LYPFT bid had been lower than TEWV
-PD services in York were improving
LYPFT writes to Jeremy Hunt over concerns about Bootham Park Hospital.
Civil servant replies on Behalf of Jeremy Hunt:
‘I share your concerns about the facilities for the delivery of mental healthservices in York and asked officials from my department to contact NHS Property Services (NHSPS) for an update. I can tell you that the company is actively working with NHS Vale of York CCG to put in place both interim and long-term solutions to improve the mental health estate in York… NHSPS has agreed a detailed programme of work with the CCG, LYPFT and the CQC to improve the clinical environment….. Phase Two works on the wards are due to commence on 7 September, with completion at the end of January 2016 for this and all works…. To address the ligature risks, work is being undertaken to, for example, install anto-ligature windows, replace doors, box in other ligature points and ensure the ceilings are anti-ligature. The work is subject to the constraints of the listed building and management arrangements that been put in place to address oustanding risks…Any changes required by tthe new provider may therefore have an impact on the above strategy and timetable, outside the control of NHSPS…. The company has just been instructed to pause new works for two weeks while the new provider reviews potentially available options for the above programme’
CQC inspection of Bootham Park hospital
Press article stating that
CQC inspection closes Bootham Park after part of the ceiling falls on their head. 30 patients are moved out.
Mental health contracts transfer to TEWV as planned
LYPFT as a whole?
Here is the CQC rating for the whole LYPFT trust for 2014/15:
The CQC rated 70% of LYPFT services as ‘good’ and one as ‘outstanding’. 25% of services required improvement and 5% were “inadequate”. Overall the trust was rated as ‘requiring improvement’. One of 5 areas requiring improvement by CQC was ‘Safety and suitability of premises’. LYPFT was only just below the national average. Other notable changes in 2014/15 included:
-New ways of receiving feedback from patients and clinicians. Improved complaints process (PALS).
-Worked with York St. John University and jointly won an award for providing classes/courses to service users.
-Staffing levels now available to see in each ward
-Worsley Court in York was closed from October 2014-January 2015 to retrain staff.
-Audits identified several areas for improvement. A recurring issue appeared to be up to date paperwork/records.
-Bootham hospital was identified as requiring improvement on admission clerking.
-York Triage service started.
-1700 staff and patients participated in clinical research.
-Planned to work with other health services in York over Eating Disorders.
-Changed internal inspection regime
– More work with 3rd and voluntary sector.
-97% of students reported a favourable experience during their placement.
-LYPFT pay at least the ‘living wage’ to their staff.
There is examples of hard effort by LYPFT, and every complaint always has an action listed to improve it. New services and collaborations are constantly launched. And you will note it was LYPFT who informed the CQC of delays to the improvement to Bootham Hospital.
My main concern is that there may have been a disfunctional ‘company culture’ in York and hope this does not exist in Leeds. Ideally I need staff members to tell me anonymously of any concerns. I would also suggest that York residents try contacting the TEWV governors.
Questions I plan to ask the board:
In 2014/15 were there proportionally more vacancies in York compared to Leeds? If so did this reflect worse job prospects?
Which CQUIN targets did LYPFT make and which did it not?
What was the average number of applicants for York or Leeds for each vacancy for 2012/13/14?
What is the % target for staff who do not feel secure in asking questions about unsafe practices?
From 2012-2015 how many external groups inspected Bootham hospital?
How many of the CQC ‘must do’ and ‘should do’ actions referred to York or Leeds?
Is there any student placement feedback for Bootham?
How many ‘serious’ incidents happened in Bootham hospital in 2012/13/14?
How much was the Bootham Park Hospital estate valued at in 2012/13/14?
One of the 10 potential risks listed in the Annual report was ‘Continuing to provide services from premises of which the trust is not in direct control that have been identified as not suitable from an environmental perspective’. Can we be confident there are no ongoing complications with the other 9 potential risks?