Documentation regarding decision to close The Orchard to female inpatients

The request was successful.

Dear Lancashire Care NHS Foundation Trust,

Please let me have copies of all documents, produced in the 12 month period ended 7 November 2014, including but not limited to meeting minutes and relevant emails, in relation to the Trust's decision to close The Orchard in Lancaster to female inpatients.

In particular, please supply documentation on the following issues related to the decision:

* impact assessment of effect on quality of care to female patients served by your organisation;
* consideration of the Trust's duties under the Equality Act 2010.

Yours faithfully,
Ms R C Horton

Freedom Of Information Requests (LCFT), Lancashire Care NHS Foundation Trust

Dear Ms Horton

Thank you for your enquiry. As per the terms of the Freedom of Information Act 2000 you will be sent a response within twenty working days i.e. 8th December 2014.

For all future correspondence please quote the reference shown in the subject line above.

Regards

Michelle

[email address]
Michelle J Brammah
Information Governance, Assurance and Compliance Lead
ISD Network Lead
Landline:01772 695300
P: Trust HQ | Sceptre Point | Sceptre Way | Walton Summit | Preston | PR5 6AW

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Stone Sue (LCFT), Lancashire Care NHS Foundation Trust

Hi Rosalind
The Trust response to your recent FOI request is as follows:

ANSWER - Under the Equality Act, the need for public bodies in England to undertake assessment of their policies, practices and decisions was removed in April 2011 when the ‘single equality duty’ was introduced. Public bodies must still give “due regard” to the need to avoid discrimination and promote equality of opportunity for all protected groups when making policy decisions. They are also required to publish information showing how they are complying with this duty – but can do that without having to carry out lengthy and detailed impact assessments.

No formal E.I.A was produced based on the temporary nature of the change. Bed stock is managed at a county level and where appropriate adjustments are made in the balance of male/female beds.

We have checked through all documents and the following emails and extracts from minutes of meetings contain relevant details around The Orchard:

From 2/9/14 Sustainability Minutes - Discussed the use of swing beds to be used once staffing levels are right on Conway, Darwen and the Orchard.

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. KM to agree if medically appropriate.

09.09.14 – Patient Flow Weekly Meetings - TH reported there continues to be pressure for male beds and AMH have between 8 – 15 female beds available.

The contingency plan

• Open a bed on Darwen Ward
• There are swing beds at the Orchard swing beds
• Change Hyndburn Ward
• Open a bed on Conway ward.

There are 8 free beds on Scarisbrick Unit and look at changing them to male beds. Need to consider that the consultant will soon be leaving and post Harbour there will be no junior doctors.

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.

Once BC and Dr B are in agreement TH will discuss with commissioners and the Exec’s.

Action:
AW to liaise with BC and KM to liaise with Dr B regarding the changes to the Orchard and to report back to TH today with outcome.

Email correspondence
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.

Just to summarise where I believe we got to:

• We will continue to work to close ward 18 by 1st Jan with a 2 bed reduction, per week, from w/c 1st Sept (by the way I would like to propose we take the 2 beds out by Tue COP each week so we can manage the impact on Wed/Thurs/ Fri and hopefully not get into problems over the weekend
• 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 swap Hyndburn (female) onto Ribble (male) to achieve a net gain of 3 male beds (loss of 3 female beds)
• We open up 1 crisis bed on Darwen permanently to achieve a net gain of 1 male bed (we’ll need to consider staffing impact)
• We open up 1 extra male bed on Conway permanently to achieve a net gain of 1 male bed (we’ll need to consider staffing impact)
• We change the ‘swing beds’ on Orchard (ASAP) to achieve a net gain of 2 male beds (loss of 2 female beds)
• Overall close 22 male beds, but gain 7 elsewhere and for the TRANSITION PERIOD ONLY use 10 Priory beds for males (=17), and lose 5 female beds.
• Ward 20 moves to ward 18 in Q4 as ward 18 is the better environment for patients. This also works well with having an acute female ward next to the female PICU, the section 136 room and an outside courtyard area. Do we need to continue then with the work and expense of anti-ligature works on ward 20???????? We did talk about a contingency ward for business continuity purposes, but perhaps estates can advise and AW?

If you are unhappy with the way the Trust has handled your request, you may ask for an internal review by contacting the FOI Lead at [email address] If you are not content with the outcome of the internal review, you have the right to apply directly to the Information Commissioner for a decision.
The Information Commissioner can be contacted at:
Information Commissioner’s Office
Wycliffe House
Water Lane
Wilmslow
Cheshire SK9 5AF
Fax: 01625 524 510

Regards

Sue Stone AMBCS
Information Governance Specialist & RA Agent

Lancashire Care NHS Foundation Trust
Phone: 01772 695300
e-mail:  [email address]

post address: Sceptre Point, Sceptre Way, Walton Summit, Bamber Bridge, Preston PR5 6AW

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