The Retreat. Photo: Courtesy of The Retreat.
The New Retreat
Jennifer Barraclough, on behalf of The Retreat’s board of trustees, gives the background to the creation of a new entity
From 1 January 2019, The New Retreat will come into existence. The new entity will maintain the Quaker commitment to mental health care and our involvement in direct provision. It will continue to have charitable status, and a Quaker-led board will continue to be responsible for its operation. But it will no longer be a hospital with inpatients; it will eventually no longer inhabit the whole of the historic forty-acre estate in York; and it will have a wider remit, working much more actively in the community through outpatient and related services.
Reaching this point has meant a long, difficult process for staff, patients, volunteers and board members. I want to set out some of the events over the past three years that have brought us to this point.
The Retreat York has been one of our largest institutions, with a worldwide reputation for compassionate care deriving from its early days when its approach to those with mental health problems was radically different from the horrors of Bedlam in the late eighteenth century. It has undergone many times of success and many of crisis during its lifetime. When I was approached in late 2015 to take over the clerking of the board, it was because another period of major change was envisaged.
Change came quickly, but of an unexpected kind. The then chief executive left, and an interim took us through to the appointment of the current chief executive in September 2016. At this point, an assessment of the longstanding issues that were troubling the organisation – financial, operational and cultural – began to be possible. A rating of ‘Inadequate’ by the Care Quality Commission (CQC) in early 2017 came as a tremendous shock. Huge efforts were made to reverse the rating, and within seven months The Retreat was again rated ‘Good’. I pay unreserved tribute to the commitment to patient care and to the dedication that staff have always shown; this has never wavered.
A painful decision
The board took specialist advice at the end of 2017, which allowed us, painfully, to accept that continuing the inpatient specialist hospital service would never now be either financially or clinically sound. The NHS commissioning agenda had shifted and we needed to change too. We made the decision in January this year to withdraw from this service and started work on the legal and consultative processes to bring this about, knowing that this would mean the end of work at The Retreat for a significant number of people. At the same time, we continued work on the best use of the estate, which is huge, complex and in many ways both underutilised and unsuitable for modern health care.
At this point, unexpectedly, The Retreat was approached by the UK arm of a large and reputable German healthcare company, Schön Klinik, wishing to continue the services relating to eating and personality disorders provided by The Retreat, and to purchase land on which to build a modern hospital. The negotiations around this have taken most of this year, and were concluded on 12 November; this is partly what has restricted full communication with a wider public.
Our first responsibility was to staff, with whom we have had to follow very careful consultation and other processes; the outcome of the negotiations could not be ensured without much effort behind the scenes; and discussions on several other fronts have also been demanding and complicated. We wanted, for instance, to continue with complex care for those with dementia at another location; this proved impossible to take further. We hoped to offer continuing services for those with learning disabilities, but new CQC regulations thwarted that. It was only in September that the board was finally able to determine the realistic shape of The New Retreat, and since then our efforts have been very clearly focused.
So, where are we now?
- Schön/Newbridge will continue to provide specialist inpatient care, initially in the current location within The Retreat but eventually in a purpose-built hospital on site. Current Retreat staff have been offered posts, saving approximately seventy-eight jobs.
- Mencap, working with the City of York Council, will take over the Learning Disabilities service, keeping nine tenants secure in their homes and saving another twenty-five jobs.
- The New Retreat will have saved, initially, posts for twenty-five people, and is expected to grow and be self-sustaining.
- All patients from the two complex dementia wards to be closed have been transferred to other locations, following very careful, individually tailored planning and consultation.
- We have worked with the pensions fund trustees to ensure that we meet our liabilities and can continue to provide the necessary safeguards.
- We have divided the estate into four plots, and have extensive professional guidance on how these might be used. There is clear interest from other institutions, including existing partners, and we are working on the pre-planning process with York city planners. The Quaker burial ground and access to it will be carefully safeguarded.
- The financial losses are being stemmed, and we expect to have retained about two-thirds of our reserves by the middle of next year, to support the transition to The New Retreat.
- The Retreat York Benevolent Fund, an independent but closely allied charity, will maintain opportunities to support Quakers to access mental health care, and to fund a range of Quaker-led mental health improvement projects across the country.
There are losses. At the end of this year, possibly up to seventy members of staff will have been made redundant; others have been asked to transfer to new situations; and there is grief and anger that The Retreat as it was could not be saved. I can only acknowledge and regret the pain caused to individuals. We have done our best throughout to provide appropriate support and guidance, both internal and external, but I know this can only go so far.
The Retreat holds an extraordinary and special meaning for all those who have been connected with it. I respect that and can do no more than say as a board we have shared that awareness and tried to act responsibly in order that there should be a future for a Quaker approach to mental health care and its provision. The loss of the physical hospital, the grand Georgian buildings and the history associated with place will cause great sadness for many and, again, we as a board have been only too aware of the great responsibility to our heritage that we have carried.
But our responsibilities cannot be determined solely by property and history. We are Friends, and we know that putting faith into action is integral to who we are. That action has to be relevant to the society in which we live. ‘We, like every generation, must find the Light and Life again for ourselves. Only what we have valued and truly made our own, not by assertion but by lives of faithful commitment, can we hand on to the future.’ (Quaker faith & practice introduction).
The future
The New Retreat will be the place from which therapists, clients and others offer services for those whose mental health requires care and treatment, but who do not need the intensive treatment of a hospital. It will be the vehicle by which the continuing duties of the present Retreat, to people, property and finances, are carried out. It will have its base in the present Tuke Centre, but new technology will enable treatment to be provided over a much wider geographical area. It will have the chance to express in modern terms enduring Quaker values: compassion, dignity, the valuing of each individual and the support to help each of us live as our true selves.
I hope that Friends and others will find this a vision that they can support; that they will be able to appreciate the reasons for the decisions taken, and be compassionate towards the struggles; and that, most of all, they will feel that The New Retreat can recreate a distinctive Quaker contribution to the desperate need for loving mental health care in our present society.
Jennifer is clerk of The Retreat’s board of trustee directors.
