APPENDIX 39
Letter from the Clinical Director, The
Bracton Centre, Oxleas NHS Trust, to The Chairman of the Committee
(MH 86)
RE: HEALTH
COMMITTEE VISIT
TO THE
BRACTON CENTRE
Thank you for your letter of 3 July 2000. We
very much enjoyed meeting members of the Committee.
1. LONG TERM
MEDIUM SECURE
BEDS
The Bracton Centre does designate 15 of our
medium secure beds as "longer term". We do not have
Modernisation Fund money to extend this provision at present although
it would certainly be possible to develop further longer term
provision (low secure or medium secure) on the Bexley Hospital
site. We also have rehabilitation (low secure and open facilities)
available within three of the four districts we serve that can
provide more on longer term provision for patients who cannot
be appropriately placed in the community.
2. Morag Murray, Service Manager informed
you of the G grade nurse liaison post who liaises between The
Bracton Centre and patient teams involved in the care of Bromley
patients. This includes Bromley patients who have been placed
in the independent sector and those in high secure hospitals.
We do not however have a specific liaison post dealing with patients
in high security.
3. HIGH SECURE
ADMISSIONS
The arrangement you refer to is part of the
Broadmoor admission protocol in that it is good practice for the
local forensic service to be involved in the assessment of patients
referred for high secure care—this is usually from prison.
In certain cases telephone discussion is sufficient if the profile
in relation to offending suggests high security is the most likely
option. More often we see the patient and make the referral to
high security ourselves. In many other cases the decision is less
clear cut. This arrangement has not always worked in practice
but the Broadmoor Admissions Panel administrator would be able
to tell you if this is now adhered to more formally—I rather
think it is. There is a particular disparity as to admission to
hospital on hospital orders on the grounds of psychopathic disorder
between consultant teams in high security and those in medium
secure services which can lead to problems at the point of proposed
transfer. The Bracton Centre accepts patients from high security
regardless of whether we were involved in the admission process
but there can be a difference of opinion as to whether the risk
management can be appropriately addressed in a medium secure setting.
Please let me know if I can clarify further.
13 July 2000
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