Exclusive: Leading trust warns NHS England over patient safety

Due to the safety concerns, Mersey Care Foundation Trust has also put forward alternative proposals to continue running services at the Calderstones Hospital site in Whalley, Lancashire. The hospital is one of the few remaining long-stay inpatient units for patients with learning disabilities. 

Closing Calderstones is a key part of NHS England’s Transforming Care programme for learning disability services, which seeks to move patients out of institution-type facilities.

Mersey Care, which acquired Calderstones Partnership FT in 2016, has since discharged around 130 patients from the site into alternative services.

It had been planning to transfer the remaining patients, who have “exceptionally complex mental health disorders” to a new 40-bed low-security unit in Maghull. But, despite NHS England stating its support, it has been unsuccessful in bidding for £35m of capital funding needed for the building work.

In a letter to the national commissioner, dated 12 February and obtained by HSJ through a freedom of information request, Mersey Care’s chief executive Joe Rafferty said the ongoing uncertainty is “posing [an] enormous risk to service users and staff”.

He said the services have already suffered high staff attrition rates, adding: “We now feel we are at the outer limits of being able to keep this site safe and even small incremental drifts in staffing numbers would pose a significant threat to the running of safe services at Whalley for some of the most vulnerable people in our society.”

Given these concerns, and recognition of the ongoing constraints on capital funding, Mr Rafferty said the trust is now proposing to retain low-security services on the Calderstones site as part of a “multipurpose community site” that would also include specialist support teams, community crisis beds, a GP surgery and affordable housing.

He added that new clinical pathways had enabled the closure of 100 beds, while the fact that services were rated “outstanding” by the Care Quality Commission in 2017 had “fundamentally reshaped” the proposition.

Some of the units at Calderstones were built within the last 10 years, and Mr Rafferty said the trust’s proposal makes “the very best use of taxpayers money and provides a solution in a palatable timeframe to implement the principles and spirit of Transforming Care”.

Mersey Care did not wish to comment further when approached, but suggested the situation was unchanged since the letter was sent.

NHS England was asked whether it would support the trust’s proposal, which would likely be necessary for it to proceed, but did not address this question directly.

A spokesman said: “We strongly support capital funding for the closure of Calderstones and will be pushing for it, providing appropriate support is in place for everyone to ensure a smooth transition to any new care service.”

He added that the last round of capital allocations was squeezed due to the emergency funds needed to complete hospital builds in Liverpool and Birmingham following Carillion’s collapse.