Health board reveals preferred option for new £67.7m mental health unit at Ysbyty Glan Clwyd

A health board has revealed its preferred option for a new £67.7m mental health unit at a North Wales hospital.

Betsi Cadwaladr University Health board intends to create an adult and older person’s mental health unit at Ysbyty Glan Clwyd in Bodelwyddan.

It comes after permission was rejected for a facility on a different part of the site because of the impact on nearby residents.

Board members have been requested to back the latest business case for submission to the Welsh Government when they meet on Thursday.

If approved the facility would replace the existing Ablett Unit at the hospital, and the older people’s mental
health inpatient facility at Bryn Hesketh.

The outline business case states: “This case aims to improve the quality of care, and support service transformation, through the development of a new Adult and Older Person’s Mental Health Unit at Glan Clwyd Hospital.

“In terms of the acute and urgent care system, there is a commitment to three inpatient units across North Wales, on the District General Hospital sites at Bangor, Bodelwyddan and Wrexham, to ensure the effective delivery of person centred, locality-based acute care.

“The intention is to manage acute and serious episodes of mental illness safely, compassionately, and effectively.”

The main goals of the development are listed as achieving the following:

• No-one waits more than 4 hours for mental health assessment in crisis;
• Once assessed, people are placed immediately in accommodation suitable for their needs. For most people, this should be their own home, with sufficiently intensive home treatment support. For some, it could mean a short-stay crisis house. For a minority, it will mean acute inpatient care;
• No-one stays longer than they need to in acute inpatient care. There are no “delayed transfers of care” due to lack of step-down support;
• No-one is admitted to an acute mental health bed outside North Wales.

The document states the case has been informed by a number of external report and investigations into the delivery of mental health care in North Wales – including HASCAS, Ockenden and Health Inspectorate Wales.

The board said there is a risk to managing patients with high levels of acuity and physical health needs at Bryn Hesketh due to its distance from the general hospital.

It also flagged up issues with the current Ablett Unit, including the mixing of older people with mental illness alongside young adults, wards that are “not fit for purpose” and privacy and dignity standards not being met.

It goes on to say: “Patients from Conwy and Denbighshire are frequently admitted to either Bangor or Wrexham because of a lack of beds.

“Current and future bed requirements have been evaluated, taking into account both service transformation and demographic changes, and the conclusion is that there are insufficient beds for both Adult and Older Person’s services.

“Also the Ablett Unit currently has a bed-based rehabilitation facility which is no longer part of the rehabilitation model of care.”

The facilities at the new unit would include:

• A 14-bed older person’s mental health ward with bedrooms with ensuite facilities, recreational spaces and improved observation.
• A 13-bed dementia care assessment unit with an end of life bedroom. This will include provision for families and carers to stay with their loved ones overnight.
• Two purpose-built 16 bedded adult wards, which will be designed flexibly to respond to gender split and future models of care.
• A de- stimulation area on each ward which will provide a safe nursing environment for high acuity patients.
• An assessment suite to enable suitable patients to be moved from the Emergency Department (ED) in a timely manner to be assessed by the Psychiatric Liaison Team.
• A small gym and increased use of outdoor space for therapeutic interventions.

The report continues: “A long list of potential options have been evaluated, to establish the most cost-effective way of delivering the project.

“The conclusion is that the best option is to build a new unit on the Glan Clwyd site.

“This option addresses the full service scope outlined in the Strategic Case, and carries the least risk in terms of implementation.

“The socioeconomic, equality and health impacts of the proposal have been assessed and found to be positive.”

The report will be examined by board members at Thursday’s meeting.