7 May 2024

NHS North West London, the local Integrated Care Board (the ICB) has today published the evaluation report for the consultation on the future of acute mental health services for adult residents living in Westminster and the Royal borough of Kensington and Chelsea. The consultation period was between 24 October 2023 and 16 February 2024. The original plan was for a 14-week consultation period, but the consultation was subsequently extended to 16 weeks.

A copy of the report, which has been prepared by independent advisors, Verve Communications, is available here. The report summarises the responses received to the consultation; it is not the ICB’s response to the consultation.

The evaluation report has found that significant efforts were made to promote participation in the consultation by the ICB, Central and North West London NHS Foundation Trust (CNWL) and both local authorities. In light of feedback received, more outreach and engagement opportunities were added and the consultation period extended. As a result, there was a high level of participation overall.  13 organisational responses were received and 770 individuals participated in meetings. A further 200 people completed the questionnaire.  

While responses to the questionnaire, taken alone, indicate more respondents in favour of the preferred option, both the ICB and CNWL are very mindful that:

  • While, of those that completed the questionnaire, more were in favour of the preferred option (no inpatient beds at the Gordon, more services in the community) than against, the margin is narrow. Views are polarised (responses tend to be ‘strongly agree’ or ‘strongly disagree’)
  • While it is not possible to quantify the responses during the meetings in the same way, to cite Lady Justice Arden: “True consultation is not a matter of simply 'counting heads': it is not a matter of how many people object to proposals but how soundly based their objections are.” This requires us to conscientiously consider the responses, including objections, and their implications for the proposals
  • From the feedback received, there appear to be three substantive areas for further work:
    • The nature and availability of the acute mental health services available to the homeless and/ or rough sleeping population, particularly in the City of Westminster
    • The efficacy of the community alternatives to crisis, and in particular which cohorts of patients these community alternatives are effective for (simply put, the less effective the alternatives, or the fewer cohorts the alternatives are effective for, the more inpatient beds will be required)
    • The model for, and the location of, the Mental Health Crisis Assessment Service, and its interdependency with other services.

Having now received the evaluation report, the ICBs next step is to consider the feedback in detail, alongside the formal response from the Inner West London Mental Health Services Reconfiguration Joint Health Overview and Scrutiny Committee, and its implications for the proposals. To commence this, the ICB have convened two stakeholder workshops (25 April and 2 May) to share the high level findings of the evaluation report, test the areas for further work, and start working with stakeholders to respond to the proposals and develop the decision making business case. The slides used in those workshops are available here.

The ICB have tested the consultation process against national guidance in the report. In the Decision-Making Business Case, the ICB will also test it against their own Involvement Charter, which was co-designed with over 200 local residents and tested with community groups and stakeholders across North West London. The Involvement Charter is available here.

At the time of writing, the ICB still intend for the board to consider that decision making business case at its July meeting. However, Westminster City Council has indicated that a report commissioned from Professor Jill Manthorpe should form part of its response. Following feedback from us at CNWL regarding material inaccuracies in that report, the ICB is still awaiting a corrected version.

They have previously indicated that the ICB and CNWL would not implement any decision made by the ICB until the JHOSC has had the opportunity to scrutinise that decision – most likely in September – and confirm that position again now. We anticipate confirming the timetable in June.