Do Nothing/Minimum Option. The Do Nothing/ Minimum Option has been developed as a benchmark against the three options detailed within this section. Strategic Scope of Option: Do Nothing Service provision: Dependency on resources and facilities within England, including medical/clinical expertise. Service arrangements: Complex transfer arrangements over the Border with an impact on cost, risk and legal requirements. Service provider and workforce arrangements: NHS England will require investment to provide capacity in the context of increasing demand to support children and young people being transferred from Scotland. Supporting assets: There are no supporting assets. Public & service user expectations: May result in negative impact on public opinion highlighting lack of provision in Scotland. If we leave things as they are this would result in unsustainable models of care, delivery and increasing demand and complexity of transferring adolescent patients into adult services. This would result in patients and families experiencing high levels of distress and delayed access and treatments. Family breakdown and young people becoming more unwell would be another negative outcome, eg social, physical and mental health deterioration. To Do Nothing would mean that the status quo would remain with all the issues and problems that have been highlighted previously within this document. Key to this is the time taken for a young person with severe mental health problems to access appropriate care. As previously stated within this Initial Agreement, two Scottish Government reports (2009 & 2014) previously proposed the development of a Scottish Inpatient Service of between 8-12 beds. Provision of a secure 8-12 bed Inpatient service will respond to the needs of 3 main care groups. These are: • Mental health; • Learning disabilities; • Autistic Spectrum Disorder; Delivery of a service to each of the above care groups requires a staff group with competencies to respond to the needs of each of the care groups. This will be facilitated by the provision of distinct & discrete areas within the layout of the new facility to provide treatment. Additionally the layout should enable a degree of flexibility to facilitate separation of individuals who present risk for others with particular vulnerabilities. Three options have been developed and are described in more detail below: Option 1 – 8 beds Option 2 – 12 beds Option 3 – 12 beds and enhanced Option One 8 Bed unit, most likely made up of 2 x 4 bed units;...
