CYPE(5)-07-20 – Paper 1
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PERINATAL MENTAL HEALTH
1.Swansea Bay University Health Board (SBUHB) welcomes the opportunity to contribute to the Children, Young People and Education Committee’s follow up work on perinatal mental health. The following information relates to the Committee’s letter of 28 November 2019.
The reason for the significant delay in Mother and Baby Unit (MBU) provision
2.The planning and subsequent implementation of any new service is complex, necessitating detailed consideration of a range of issues including service models, integration with other services, workforce models, capital and estates planning, and patient pathways. The planning of specialised services brings additional complexity, with necessary procedures to be followed to meet external commissioner requirements in additional to internal scrutiny and governance expectations. The Health Board has always endeavoured to progress plans and meet external requirements in a timely way.
3.The Health Board responded positively to the Welsh Health Specialised Services Committee’s (WHSSC) invitation for expressions of interest to develop and host a regional inpatient unit for Perinatal Mental Health in South Wales in June 2018. Detailed work was then undertaken on options, with initial considerations presented to the WHSCC Management Group on 20th December 2018. A sequence of papers were presented to the WHSCC Management Group providing increasingly detailed proposals covering costs, timescales, staffing models, and contracting frameworks over the course of the first half of 2019. Papers considered by the Management Group in August and September 2019 were focused on the option of a new build Mother and Baby Unit on the Neath Port Talbot site.
4.Given the timescales involved in the new build proposal, the Health Board was asked in late September 2019 to reconsider an interim solution (the option of an interim solution was considered but ruled out earlier in the process). Two potential sites were visited within a fortnight and their suitability was benchmarked against relevant standards. Subsequent to this, a paper on an interim solution was prepared for, and considered by, the WHSCC Management Group on 28 November 2019. The Management Group supported the proposal and agreed that the recommendation of a new build be withdrawn until the capital position was confirmed with Welsh Government and noted that the interim model would allow for an earlier opening.
5.Earlier this month the WHSSC Joint Committee supported an interim 6-bed Mother and Baby Unit at Tonna Hospital. The Health Board undertook work to determine the capital requirement for the interim unit, and Welsh Government subsequently confirmed the capital funding requirement at the end of January.
The current situation in relation to MBU provision, including detailed timescales for plans, associated costs.
6.We understand that WHSSC have shared with the Committee the latest proposals considered by the WHSSC Committee on 28th January 2020, which outlines the timescales and costs involved. As noted above, the capital funding requirement has recently been confirmed by Welsh Government and the Health Board will now urgently proceed with its plans.
7.In parallel a Task and Finish Group is being set up to undertake a full feasibility assessment of a permanent solution proposed for the Neath Port Talbot Site.
Any interim plans that are in place to provide specialist in-patient perinatal mental health support in the absence of MBU provision
8.Currently all Mother and Baby placements are commissioned through NHS England. Alternatively, Mothers can be admitted locally to acute wards, but unfortunately without their baby. Our perinatal community team undertakes in-reach support to England providers and seeks to keep in regular contact with the progress of Mothers and babies who are inpatients of other providers, and routinely attend discharge planning meetings to support continuity of care. The team also provides inreach support and directly works with Mothers admitted to local acute wards.