Government “Sets Record Straight” Following Mental Health Board Report Criticism - Recommendations “Have Been Acted Upon”
The Government says it notes the criticism of the GHA after the publication of the Mental Health Board’s recent report and says it wishes to “set the record straight.” The Government says that all of the recommendations of the 2019 report have been acted upon.
A statement continued: “It is important to understand that the Board, consisting of six members; two registered medical practitioners, one barrister and three lay members, was formed by this Government as recently as April 2018.
“Under the Mental Health Act, Section 115(1), Board’s functions are to satisfy itself as to the state of the Ocean Views (OV) facility, and the Community Mental Health facility (CMHT) at Coaling Island, their administration and the treatment of patients.
“The first annual inspection was carried out by Dr Renee Beguelin and Emily Adamberry Olivero on 26 March 2019. A number of issues and subsequent recommendations were detailed in the ensuing report, and established the baseline situation in Gibraltar’s Mental Health Services.
“Since that time, all of the recommendations have been acted upon, as summarised to follow:
- Communication and Coordination between A&E and Mental Health has been significantly improved. Patients are escorted to St Bernard’s, Primary Care Centre and A&E appointments by a member of nursing staff, and the senior nurse on duty informs the Clinical Nurse Manager at SBH in advance;
- New job plans have been introduced in the last year in order to address the availability of doctors, such that staff and patients are able to access a doctor from Monday to Friday who is not rostered to complete clinics;
- Ministry approved the increase of clerical support in July 2019 with two extra clerical staff in OV and one extra in CMHT;
- The issue of documentation and the delay in obtaining reports has been resolved. BIGHAND, dictation software, was introduced in May 2019 and outstanding letters and reports have been cleared. Capacity Assessments referred to in the Board Report have been completed;
- Mental Health Services have now, since the report findings, pharmacy input for one session per week, with additional support provided by the pharmacy at SBH. This input is under continual review to scale services appropriately while also supporting all other SBH wards;
- Staff undertake an induction period on commencement of employment, overseen by the Matron and the newly appointed Practice Development Nurse and recorded in a Competency booklet. This induction includes all policies, GHA and department specific, and Mental Health Act training days;
- Staff are now being offered two year fixed term contracts in order to reduce turnover and ensure staff stability;
- Training is being provided for Mental Health Practitioners by the School of Health Studies. This training commenced in September 2018 and will be completed in September 2021;
- Records have been centralised and the Matron currently undertakes weekly audits of all records with the Charge Nurses and Sisters. All section papers are scrutinised and vetted by the Mental Health General Manager. More stringent processes have been introduced and medical staff, including nursing staff, have been made aware of the role, function and importance of the Section Opinion Appointed Doctor (SOAD);
- OV has medical reviews twice weekly with consultants from SBH. Patients are escorted to PCC for appointments if they cannot be facilitated at OV and if they are part of a patient’s rehabilitation programme, and at times, reintegration back into community living. We now have A&E Mental Health Liaison Nurses, and we have identified an area within A&E for patients to be seen. Waiting times has been reduced significantly, as a dedicated mental health nurse is available 24/7 to ensure patients are seen promptly.
- Another 24/7 supported accommodation flat in the community is being commissioned presently. Kent house is staffed as and when required, similar to the flats in OV. In terms of staffing these accommodations, the nursing complement has been increased by two since August 2019.
“Crucially, a second annual inspection report was carried out on 24 February 2020. The recommendations of this new report confirm the improvements in communication, staff contract stability, local Mental Health Practitioner training, good use of the Rock flats and Kent House.
“Key areas for improvement going forward, and as recommended by this latest report, include updating the Code of Practice and disseminating to staff, and a review of staffing to consider whether junior doctors would be appropriate for the service and could be supported such that the junior doctors would receive a good level of training.”
Minister for Health and Care, Paul Balban, said: “We very much welcome the thorough objective assessments carried out by the Mental Health Board. They have helped us establish not only a baseline for our Mental Health services, but also have advised us on how we can improve the service. I am extremely grateful to the Board for their hard work and diligence, and to all the Mental Health services staff who have shown their commitment to change and improvement for the benefit of patients and our community. As a result, we have been able to resolve many of the report’s findings, and will continue to work closely with the Board.”
