The unit, formerly known as Calderstones, is based at Whalley near Clitheroe. It is due to shut as part of a nationwide programme to reduce reliance on hospital beds for people with conditions including autism.
The number of inpatients at the site has been cut by two thirds to around 100 since 2016, but Lancashire’s Transforming Care Partnership (TCP) is under pressure to introduce a new model of care for the adults it looks after before the unit finally closes for good.
“Questions are being passed to [NHS England Chief Executive] Simon Stevens directly,” Andrew Simpson from NHS England told a meeting of the Lancashire Health and Wellbeing Board.
“He [is] very keen to see the institution close, but we have to think about the welfare of the remaining patients,” Mr. Simpson added.
Meanwhile, the woman in charge of overhauling care for adults with learning disabilities in Lancashire says the “last place” she would want her own son to be is a hospital bed.
But Rachel Snow-Miller - who is the Senior Responsible Officer for the Transforming Care Partnership and has a son with a learning disability - accepted that the county could never “entirely eliminate” the need for inpatient beds.
Plans are being drawn up to create a new model based on between 14 and 16 assessment and treatment beds, along with 10 so-called step-down placements to prepare patients to move to supported living in the community.
A public consultation on the proposal is due to begin in October, before a final decision is reached in March 2019.
“These are our families and we want them to be living near us and looked after in Lancashire,” Rachel Snow-Miller said. “If you’re a Chorley person [who happens] to have been in hospital and you want to go back to Chorley, we want to support you to go back to Chorley.”
County Cllr Graham Gooch, the Member for Adult Services on Conservative-run Lancashire County Council, asked what was being done to prepare communities which may play host to people leaving a hospital setting.
“There’s a facility in Lancashire [to which] people with challenging behaviour move - and it’s causing enormous amounts of complaints from the neighbours,” County Cllr Gooch said. “They say their life is being made a living hell.”
Sharon Martin, from the TCP, responded: “It’s difficult to maintain somebody’s confidentiality and their right to live independently [whilst working] with communities to prepare. If we work better through primary care, we will be better placed to work with [those] communities.”
Andrew Simpson told members that there would be a narrow definition of those patients requiring secure accomodation in future.
“We’re not talking about challenging behaviours,” he said. “We’re talking about those people with an offending history who have been through the courts.”
Medium and low-secure accomodation for the county is set to be developed at Maghull on Merseyside, a legacy of the fact that Mersey Care NHS Trust took over responsibility for the former Calderstones site.
But the new facilities are not due to be completed until 2020/21. The committee heard that may mean Whalley remaining open for another three years, although board papers suggest that such a timeline “will not be acceptable to NHS England”.