PROPOSALS to build a £67.7 million replacement for the Ablett mental health unit at Glan Clwyd Hospital are being discussed this week.
Members of the Betsi Cadwaladr University Health Board (BCUHB) will be asked on September 23 to approve the Business Case – for the Adult and Older Person’s Mental Health Unit – ahead of submission to Welsh Government.
The facility, which aims to improve the quality of patient care, will not only replace the existing Ablett Unit at the Bodelwddan based hospital but the Older People’s Mental Health inpatient facility at Bryn Hesketh in Colwyn Bay.
The Outline Business Case (OBC) [September 2021] for board approval states: “Strategically, the case is driven by Together for Mental Health, Welsh Government’s 10 year cross-governmental strategy to improve mental health and well-being. The key local strategy is BCUHB’s Together for Mental Health in North Wales, which has a strong focus on: health promotion; early intervention; providing services which are community-based wherever possible; and supporting recovery.
“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 through a service within which no-one waits more than four hours for mental health assessment in crisis; Once assessed, people are placed immediately in accommodation suitable for their needs.
“No-one [will] stay longer than they need to in acute inpatient care and no-one is admitted to an acute mental health bed outside North Wales.”
Currently, at Bryn Hesketh, there is a “risk” when it comes to managing patients with high levels of acuity along with co-occurring physical health needs so far away from the acute general hospital.
Bryn Hesketh is also not regarded as a “sustainable facility” in terms of national environmental and clinical quality standards.
At the Ablett Unit, there is a range of concerns – mixing older people with mental illness alongside young adults.
The document states: “This is not appropriate and does not deliver good patient experience; ward environments that are not fit for purpose; privacy and dignity standards that not being met; an electroconvulsive therapy (ECT) facility that is not fit for purpose; a pharmacy that is too small and cannot support individual consultations; very limited therapeutic areas and opportunities for exercise; insufficient provision for patient assessment.
“The absence of a de-stimulation area; poor staff facilities; and traditional single office accommodation for administration which does not support co- location of specialist teams and agile working.”
At present, patients from Conwy and Denbighshire are frequently admitted to either Bangor or Wrexham because of a lack of beds.
The new build will include a 14-bed Older Person’s Mental Health functional ward that incorporates bedrooms with ensuite facilities, improved circulation and recreational spaces and improved observation; A 13 bed new fit for purpose 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] and two purpose-built 16 bedded adult wards, which will be designed flexibly to respond to gender split and future models of care.
There will also be a de- stimulation area on each ward; an assessment suite; a small gym; a new 136 suite with an additional assessment room; Increased therapeutic space indoors and outdoors; Provision of a modern accredited regional ECT suite; removal of the locked rehabilitation ward; staff change and rest facilities and a café and bright reception area.
Services at the Ablett and Bryn Hesketh will be maintained while the new unit is constructed.
The capital cost of the preferred option is £67.7 million. This is an increase of £1.73 million compared to existing arrangements.
In January, outline planning permission to build a replacement for a “not fit for purpose” mental health unit at Ysbyty Glan Clwyd was refused by Denbighshire councillors – against officer recommendations.