The Briary Unit at Harrogate District Hospital has this week closed its doors for the final time as inpatient mental health services transfer to York. 

The hospital wing, which offered specialist inpatient care for people suffering with mental health problems, is now sitting empty, as services are provided in the newly-built Foss Park Hospital on the north side of the city. 

A spokesman for Harrogate and District NHS Foundation Trust, which is not responsible for mental health provision, said it was now considering how best to use the space.

Naomi Lonergan, director of operations for North Yorkshire and York at Tees, Esk and Wear Valleys (TEWV) NHS Foundation Trust which runs mental health services for the Harrogate district, said: 

“Over the last few weeks our services have been transferring from the Briary Wing at Harrogate District Hospital as planned in phased approach. All services will have vacated by the end of this week and we have been working with services users, carers and partners to keep them updated on these changes.” 

The Briary Wing is now unoccupied

Alongside TEWV, the decision to close the Briary Unit last year was made by Harrogate and Rural District Clinical Commissioning Group (HaRD CCG), which has since been merged with two others to form North Yorkshire CCG. 

A spokesman for the new CCG said:

“Relocating the inpatient beds for Harrogate patients to York has released £500k which we are investing to expand and improve community mental health services which includes crisis. This is in line with one of our key principles which is to keep and treat people at home. The mental health transformation project is expected to reduce admissions, and when people do need to be admitted to reduce their length of stay.  

“We are conscious of the impact on families and carers and this was picked up as part of the engagement exercise. TEWV and the CCG are looking at volunteer drivers to help but also recognise that this is a difficult time.” 

Growing demand

With the full impact of the coronavirus crisis on mental health still to become clear, concerns have been raised that the new arrangements will not meet growing demand over the coming months. 

Cllr Geoff Webber, pictured left, who represents Bilton and Nidd Gorge on North Yorkshire County Council, last year criticised the decision to close the Briary Unit, saying the district’s residents had “been screwed” by TEWV and HaRD CCG, which made the decision. 

This week he said: “My concern remains that when there is pressure on the facility in York – as I’m sure there will be with the fall out from the pandemic – then Harrogate patients will be come second in the queue and possibly referred to Middlesborough or even further away. Community-based services will be unable to cope in the current situation.” 

The CCG spokesman said their modelling suggested the 72 beds in York would be sufficient, especially with an increase in community-based services, but there was always the possibility that patients would have to be treated further afield. Meanwhile, services have been adapted during the coronavirus crisis.

Ms Lonergan said: 

“We continue to deliver our services. We have introduced phone and video contacts for community appointments, where it is appropriate, and this has worked well. During this time we are also trying to maintain a level of contact with all patients, supplemented by more frequent contact by volunteers or other staff where appropriate. In the community, where it is identified that people do require face-to-face support, Trust staff can still visit people at home and they are taking the necessary precautions when doing this.”  

She added that the crisis service, offering 24-hour support, was continuing to operate and directed people to the website for more information.

Read more: From building a new hospital to moving all services to York – how did we get here?

Are you or a family member affected by this story and want to share your concerns? Please get in touch  – contact@thestrayferret.co.uk  

When the decision was taken a year ago to close the Briary Wing and move inpatient mental health services to York, it marked the end of a long and intensely political debate about the future of adult mental health inpatient facilities in the Harrogate district.  

Plans had been well advanced for a 36-bed facility at Harrogate’s Cardale Park. Planning permission had been approved and work had begun when – a year ago – Harrogate and Rural District CCG and the Tees, Esk and Wear Valleys (TEWV) NHS Foundation Trust (which runs mental health services) voted to halt the project and focus on sending patients to a new facility in York.   

The site at Cardale Park where the mental health inpatient unit was set to be built

Harrogate and Rural District CCG defended its decision at the time, arguing the move to York was to produce “the best possible care” and it wanted to invest more in community care to prevent people needing inpatient facilities – but the reality was the CCG had a £14m deficit and had to prioritise funds.  

To many politicians of all persuasions, it was another example of the long term chronic under-funding of mental health services. Conservative councillor Jim Clarke, the Head of North Yorkshire County Council’s Scrutiny of Health Committee, said at the time:  

“This is not a recent problem, this is the result of years, decades of underinvestment in mental health.”  

The Liberal Democrats, too, expressed concern that patients and their families would have to travel to York – county councillor Geoff Weber said Harrogate had been “screwed by the CCG and NHS”. 

This week, however, the CCG has reiterated its statement that the decision was not based on finance.

A spokesman said:

“The decision was made based on best practice in providing high quality mental health inpatient services and expanding the services locally available in the community. The decision to invest in community services and redeploy inpatient services to York was taken after extensive engagement.

“The solution adopted was the only option that maximised patient safety and experience, while remaining true to its commitment to providing care as close to home as possible.”

Decision came against a backdrop of health service debt and restructuring  

Since 2008 mental health services (both inpatient and community based services) in the Harrogate district have been operated by Tees, Esk and Wear Valleys NHS Foundation Trust, a specialist mental health Trust. Clinical Commissioning Groups effectively “buy” services such as inpatient mental health beds from the Trust. 

The decision to close the Briary Wing and reject the Cardale Park option came at a time of change for the Harrogate District CCG.  In November last year NHS England agreed to merge Harrogate with two other CCGs: Hambleton, Richmondshire and Whitby, and Scarborough and Ryedale.   

The North Yorkshire CCG was formed on April 1st 2020 – in the height of the current coronavirus crisis – with a requirement to cut 20% from its admin budget.  

This new North Yorkshire CCG will now be responsible for “buying” mental health services from TEWV for the Harrogate district. The CCG though has a projected deficit of £18m for this coming year and has proposed a £72m savings programme over the next 5 years.

The Stray Ferret put a series of question to the CCG and got the following responses: 

Will the 72 beds in York be enough? If it is full, where will inpatients from our district be sent? 

“Through the modelling undertaken we are confident that there will be enough beds at the new unit, especially given the expectation that there will be a reduction in admissions and length of stay. However, as now, it is sometimes more clinically appropriate for patients to be placed elsewhere.”

Will the newly merged CCG make its administrative and managerial cost savings, including the proposed £72m? 

“The CCG is now operating under a partnership arrangement with TEWV for mental health and learning difficulties which also includes NYCC.  The partnership is committed to delivering the mental health investment standard which ensures that investment into mental health is protected but there is acknowledgement that services need to transform and innovate to deliver improvements and meet an increasing demand for services.

“The 20% reduction in running costs applies to all CCGs and this has been achieved through the recent merger to form the North Yorkshire CCG.”

What impact will the current pandemic have on all health services and what will be prioritised as a result?

“Under the North Yorkshire Mental Health and Learning Disability Partnership, we are working jointly with TEWV to agree how the funding available is used.”