A Vital Mental Health Service in Norfolk Due to Close as a Result of Insufficient Funding

Ashcroft is a CQC registered Residential Care Service for women in the village of Wicklewood, near the market town of Wymondham in Norfolk. It was established in 1986 to support women with severe and enduring mental health needs. Julian Support has been providing the service since 2012

The women who access Ashcroft come from very difficult circumstances. Many of them have a diagnosis of Personality Disorder and self-harm or use drugs and alcohol as a way of coping with their experiences. Most of the women have experienced periods of extreme crisis in their lives that have resulted in hospital admissions and they often speak of traumatic childhood experiences.

Ashcroft has been a place where they can feel safe, come to terms with some of their experiences, develop new strategies for coping and start planning to move towards independence. Some of the women use the service for respite and this is a lifeline that enables them to get a break from the pressure in their lives with staff on hand to support them.

Norfolk & Suffolk Mental Health Foundation Trust has commissioned a number of beds at Ashcroft to help the pressure on hospital beds. These beds are for women who are medically fit for discharge, but due to housing and social reasons are unable to go back home. Women are able to move on from hospital in a safe and timely way and the Ashcroft staff team are able to support them to manage the transition back into the community. This helps Norfolk & Suffolk Mental Health Foundation Trust to manage the pressure of out of county placements as it frees up beds in hospital.

We have a dedicated and skilled staff team who are passionate about the service that they deliver. They work in very challenging circumstances, conveying a huge amount of compassion and respect for the women that they support. Over the last few years the team has had to adapt to lots of changes and whilst this has been difficult, they have kept the needs of the women they support as their main priority.  

The service works very closely with our statutory colleagues at Norfolk & Suffolk Mental Health Foundation Trust and within Norfolk County Council Adult Social Care departments.

Following a period of negotiation with Norfolk County Council commissioners, Julian Support was notified of the available funding to continue the contract for the service beyond April 2015. The funding was insufficient to deliver the service safely for either the staff or service users. It would have resulted in one member of staff being on site at any one time and this was simply unacceptable given the high level of need and risk taking behaviour of the people who access Ashcroft. The Julian Support Board of Trustees confirmed that they could not sanction this level of risk at a meeting on the 20th November 2014 and Commissioners were notified of the outcome the following day.

The closure of Ashcroft marks a very sad chapter in the provision of local mental health services in Norfolk and we are concerned for how vulnerable women will access the support that they so desperately need in future. The impact of the closure of Ashcroft will be felt widely and it will undoubtedly put pressure on already stretched community services. There is a real risk that this will lead to increased use of A&E departments and acute psychiatric services, which are inappropriate, financially costly and a backwards step in terms of someone’s on-going recovery. Emergency services should always be the last resort, but with the closure of Ashcroft we fear that they will become increasingly a first port of call.

Pip Coker, CE of Julian Support said:

We all understand the financial position Norfolk County Council is in but If NCC cannot afford to commission a specialised service like Ashcroft they need to be up front  about that and then they need to consider the impact of that decision on mental health services locally. It is not acceptable for commissioners of services to ask providers to cut services to a point where they are no longer safe nor are they able to deliver the service that is actually required. We are supposed to have integrated commissioning whereby health and social care work together. What will be the cost to the wider mental health system of reaccommodating the women who live here?  There is no comparable service so the women will end up in hospital or in other much more expensive provision. Have they assessed the impact of their decisions both financially and on the lives of the women who use the service?  This is a mechanism to achieve short term savings only, as far as I am aware NCC haven't  discussed the implications with the mental health trust.
 
What we need is someone to step back and look at the bigger picture of mental health provision in Norfolk.
 
Norfolk County Council said this was their final offer but have now offered to meet with us again.I don't yet know the purpose of that  meeting but let's hope that someone can do some joined up thinking and we can resolve this situation.