The Kent and Medway NHS Joint Overview and Scrutiny Committee met on 2 September 2026 to examine proposals to decommission the Bedgebury Unit, a 10-bed forensic pre-discharge rehabilitation service, and replace it with a community-based model backed by £4.5 million of new investment.

A proposal to close a specialist forensic mental health unit in Kent and replace it with community-based care was examined by a joint NHS scrutiny committee when it met on 2 September 2026.

The Bedgebury Unit is a 10-bed forensic pre-discharge rehabilitation service commissioned by NHS Kent and Medway Integrated Care Board (ICB) and provided by Kent and Medway Mental Health NHS Foundation Trust (KMMH). Established in 2016, it was designed to support individuals moving from medium secure forensic services into community living. The unit sits within the Trevor Gibbens Unit forensic estate and is described in the papers as ring-fenced for a defined cohort of Kent and Medway patients; it is not part of the wider acute mental health inpatient bed base.

Why the unit is proposed for closure

A joint review by the ICB, KMMH and the Kent, Surrey and Sussex Secure Care Provider Collaborative concluded that the service is no longer aligned with its original service specification, current NHS England rehabilitation commissioning guidance, or contemporary rehabilitation and recovery models. The review found that Bedgebury does not operate as a recognised Level 1 or Level 2 rehabilitation service, does not have a dedicated multidisciplinary rehabilitation team, and is embedded within a medium secure environment considered more restrictive than current models would expect.

The papers also state that the current model can lengthen a patient’s overall care pathway by introducing an additional inpatient step between medium secure care and discharge, potentially extending time spent in restrictive settings.

Financial picture and planned reinvestment

The ICB stated in its report that the proposal is not financially driven and does not represent a reduction in mental health investment. The annual commissioned value associated with Bedgebury is approximately £1.73 million, of which around £680,871 has been identified as potentially releasable. The papers say this figure is lower than the cost of the proposed replacement community model.

Alongside the proposed decommissioning, the system said it has secured £3.5 million for a countywide Assertive Outreach Team and £1 million to improve step-down capacity and patient flow. The papers note that for a period the ICB would fund both the existing inpatient provision and the new community model simultaneously.

Concerns raised through scrutiny

Both the Kent Health Overview and Scrutiny Committee, which considered the proposals on 3 June 2026, and the Medway Health and Adult Social Care Overview and Scrutiny Committee, which considered them on 16 June 2026, determined that the proposed decommissioning constituted a substantial variation in the provision of health services. That determination triggered the referral to the joint committee.

Four recurring concerns had been raised through the scrutiny process: whether the proposal is financially driven; whether closure would reduce acute mental health bed capacity; whether it would increase adult social care demand; and whether sufficient assurance exists that patients will be supported safely through alternative pathways.

The ICB acknowledged in its report that scrutiny engagement could have occurred earlier. It said that since new admissions to Bedgebury were paused, there had been no identified increase in mental health crisis service presentations by patients discharged from the unit, and no evidence of additional adult social care demand attributable to the proposed changes.

Next steps

The joint committee was asked to consider whether the assurances provided had satisfactorily addressed the concerns raised, and to provide any recommendations for the ICB to consider before any final commissioning decision is made. The committee also holds delegated powers from both scrutiny committees to request the Secretary of State to call in the proposal if it wishes to do so.

The council had not published the minutes of the meeting at the time of writing, so the committee’s decision is not yet on the public record.

Sources

Top image: illustrative, computer-generated. Illustrative AI-generated image. This is not a photograph of the Bedgebury Unit, the Trevor Gibbens Unit or any real identifiable building.