‘Exceptional’ demand for mental-health care revealed

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INPATIENT demand in acute adult mental health has been so exceptional that bed capacity has been increased to cope.

The latest Quality and Performance Report, which assesses key targets across health services, shows continued pressures in mental health.

Bed occupancy in adult acute services in March was 108.5%, compared to 71% this time last year, a figure not reached before in the 12 months covered in the report.

Anything above 88% triggers an ‘exception report’ and the figure has been rising from a low at the start of the year of 70%.

‘Occupancy has been exceptionally high during March, with the requirement to utilise beds to admission and temporarily utilise bed capacity in the older adult service. This is being reviewed by the senior leadership team, including a review of all delayed discharges/transfers of care and our current home treatment capacity,’ the report states.

Home treatment may provide an alternative to people being admitted, it added.

A rolling figure for adult acute admission per 100,000 population is 264.1, up from 232.3 a year ago. Older adult acute bed occupancy has triggered concerns since May 2021, although at 87.4% it has fallen from a high of 96.1% in June.

‘A significant percentage of service users within the older-adult bed base are now considered “delayed” in hospital as a result of challenges in obtaining appropriate community placements,’ the report says. ‘This is an ongoing issue and work is under way to explore potential solutions to this.’

The waiting list for Jersey Talking Therapies has also been flagged throughout the year. Of those clients who started treatment in March, 41.4% had to wait more than 18 weeks, although that is a fall from 50% in January and February.

This has been attributed to staff vacancies in the service, increased demand and the volume of clients who needed longer therapy sessions.

The number waiting for assessment in March was 146, which has increased from 119 in February. A total of 118 people were referred to JTT in March, which is well above the monthly average of 100.

‘Despite this, there are 0% waiting for assessment over 90 days and only 3% of clients attending for assessment who waited over 90 days in March,’ the report says.

‘The team continue to have some vacancies and staff redeployed to support the wellbeing team offer, which impacts on activity capacity within the team. We are currently recruiting into the vacant posts at step 2, which will help support the rapid assessment of service users accessing JTT, and have recently been exploring the use of additional agency capacity within the team.’

The performance report also shows that March saw a rise in emergency demand in the Jersey General Hospital and patients with Covid. More than 50% of patients were waiting more than 90 days for elective admissions, a steady increase from 39.9% this time last year. The target is 35%. ‘There continues to be inpatient and discharge challenges which is having an impact on elective admissions. We are continuing to review and convert to day surgery where possible,’ the report says.

Diagnostics were also highlighted, with 68.3% of patients waiting more than 90 days.

There has been no DEXA [bone density] scanning service for two years because of a broken machine and no radiologist.

A new radiologist began working in February and the number waiting fell by 13% in a month, the report says.

There has also been a 12% decrease in the number of people waiting for an endoscopy between December and March after the start of a Faecal Immunochemical Testing programme. An additional gastroenterology locum started in mid-March.

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