29 July 2020

By Liz Romaniak, Director of Finance, Contracting and Facilities, and Deputy Chief Executive, Bradford District Care NHS Foundation Trust

As a provider of inpatient and community-based mental health services in West Yorkshire, we welcome the national commitment to parity of esteem for mental health services and much-needed revenue investment to support service improvements.

But it’s crucial that parity of esteem also applies to capital funding for mental health facilities and our core mental health service provision.

We also welcome the spotlight on mental and physical health inequalities that are now in sharp focus because of the pandemic. National and local Public Health analysis has clearly demonstrated a stark link between deprivation, health inequalities and disproportionately adverse health outcomes.

We know that mental health inpatient environments impact significantly on individuals’ wellbeing and recovery.

Bradford District, where our biggest mental health hospital is based, has a population of around 540,000 and is ranked the 5th most income-deprived and 6th most employment-deprived local authority in England. Despite our and our partners’ best collaborative endeavours, this has inevitable adverse health consequences.

We know that mental health inpatient environments impact significantly on individuals’ wellbeing and recovery.

Mental health hospitals have not featured in the major hospital programmes that are backed nationally through the Health Infrastructure plan. But it shouldn’t be an either/or in terms of acute hospital or mental health facility investment decisions. We need both to support physical and mental wellbeing. There has never been a greater need for mental health facilities that are equipped to provide safe and high-quality therapeutic environments to support recovery.

Our mental health hospital site at Lynfield Mount in Bradford, has been developed incrementally, with separate and unconnected units. The largest - a 1960s in-patient block with 77 beds - no longer supports therapeutic, recovery-focused and safe care.

There has never been a greater need for mental health facilities that are equipped to provide safe and high-quality therapeutic environments to support recovery.

Wards range from 22 to 25 beds and lack en-suites that afford basic privacy and dignity, and support infection prevention and control in the current pandemic. Cruciform ward layouts impact on staff’s ability to see all areas and to observe individuals who are at their most vulnerable, and at increased risk of self-harm. Cramped footprints mean that there is minimal recreational or space for exercise, which we know is vital for wellbeing and recovery.

Our staff, like countless others across acute mental health services, are striving every day to provide the best quality care for our patients. But there are limitations with outdated facilities that simply don’t reflect current best practice.

At Lynfield Mount, on-going maintenance challenges and the wards’ age and design mean it’s difficult to regulate temperatures, requiring additional measures to ensure the comfort of staff and patients, and to ensure the safe storage of medicines. The existing ward footprints cannot be refurbished to provide the circulation, outdoor and therapeutic spaces, with limited access to gym and other exercise facilities, to support wellbeing.

In contrast, our 22-bed purpose-built dementia assessment unit on the same site, provides a state-of-the art care facility that’s ‘gold’ accredited by the Dementia Services Development Centre (DSDC) at Stirling University.

Whilst we are continually striving to improve our mental health services, we need £70m external capital funding to ensure that our hospital environments keep pace to enable recovery

Financial difficulties, increased general anxiety, debt, unemployment, bereavement, domestic violence, alcohol and substance misuse, are all likely consequences of Covid-19. Health inequalities mean many of these were already a challenge for some of our communities, so impacts on mental wellbeing will inevitably be exacerbated in the medium term.

Whilst we are continually striving to improve our mental health services, we need £70m external capital funding to ensure that our hospital environments keep pace to enable recovery, so that patients can return to their communities as soon as they are able, with support.

It’s what our communities rightly deserve.

Photo by Eduard Militaru on Unsplash