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Govt ‘sets record straight’ on Mental Health Board Report

The Gibraltar Government has “set the record straight” following criticism over issues and recommendations outlined in the 2018/2019 Mental Health Board Report.

The Government highlighted that “all recommendations” have been acted upon since receiving the report last year, after its authors found a “vital and increasing” need to establish a more cohesive strategy for mental healthcare.

This report was the first carried out by the Mental Health Board since it was formed in 2018 and analyses the state of the Ocean Views and the Community Mental Health facility at Coaling Island, their administration and the treatment of patients.

The first annual inspection was carried out by Dr Renee Beguelin and Emily Adamberry Olivero in March last year and a number of issues were detailed in the ensuing report.

The Government said this established the baseline situation in Gibraltar’s mental health services, adding communication and coordination between A&E and mental health has been “significantly improved”.

“We very much welcome the thorough objective assessments carried out by the Mental Health Board,” said the Minister for Health and Care Paul Balban.

“They have helped us establish not only a baseline for our Mental Health services, but also have advised us on how we can improve the service.”

“I am extremely grateful to the Board for their hard work and diligence, and to all the Mental Health services staff who have shown their commitment to change and improvement for the benefit of patients and our community.”
“As a result, we have been able to resolve many of the report’s findings and will continue to work closely with the Board.”

One of these findings included the need for further 24/7 supported accommodation, with a further flat now being commissioned.

The Government added in terms of staffing these accommodations, the nursing complement has been increased by two since August 2019.

Further recommendations that have been met include new job plans to address the availability of doctors; an increase of clerical support; staff now being offered two-year fixed term contracts in order to reduce turnover and ensure staff stability; staff undertaking an induction period on commencement of employment, overseen by the Matron and the newly appointed Practice Development Nurse and recorded in a competency booklet; and records being centralised and the Matron currently undertaking weekly audits of all records with the Charge Nurses and Sisters.

“All section papers are scrutinised and vetted by the Mental Health General Manager,” the Government said.

“More stringent processes have been introduced and medical staff, including nursing staff, have been made aware of the role, function and importance of the Section Opinion Appointed Doctor.”

The Government said the issue of documentation and the delay in obtaining reports has been resolved.

“BigHand, dictation software, was introduced in May 2019 and outstanding letters and reports have been cleared,” the Government said.

“Capacity Assessments referred to in the Board Report have been completed.”

Since the report findings Mental Health Services now have pharmacy input for one session
per week, with additional support provided by the pharmacy at St Bernard’s Hospital, and this is under “continual review”.

Training has also been provided for Mental Health Practitioners by the School of Health Studies and training commenced in September 2018 and will be completed in September 2021.

The Government said that Ocean Views has medical reviews twice weekly with consultants from St Bernard’s Hospital.
“Patients are escorted to Primary Care Centre for appointments if they cannot be facilitated at Ocean Views and if they are part of a patient’s rehabilitation programme, and at times, reintegration back into community living,” the Government said.

“We now have A&E Mental Health Liaison Nurses, and we have identified an area within A&E for patients to be seen. Waiting times has been reduced significantly, as a dedicated mental health nurse is available 24/7 to ensure patients are seen promptly.”

A second annual inspection report was carried out on 24 February 2020, the Government added.

“The recommendations of this new report confirm the improvements in communication, staff contract stability, local Mental Health Practitioner training, good use of the Rock flats and Kent House.”

“Key areas for improvement going forward, and as recommended by this latest report, include updating the Code of Practice and disseminating to staff, and a review of staffing to consider whether junior doctors would be appropriate for the service and could be supported such that the junior doctors would receive a good level of training.”