The National Audit Office has reported progress at Mount Carmel Hospital and in the mental health service, after recommendations it made in a strategic review in 2018.

In a follow-up report issued on Wednesday, the audit office said progress had been made in the implementation of half of its recommendations, including those considered as being the most critical.

Among them was a call for improvements to the hospital's structure, safety, and ambience, with refurbishment and structural works being undertaken on more than half of the hospital’s wards.

Still, the office said it remained concerned by the state of the remaining wards which, since the 2018 report, had largely remained in poor condition.

"This Office considers that such an environment undoubtedly still impinges on the patients’ and staff’s overall wellbeing," the follow-up report says.

The audit office said it was a concern that an attempt to secure a temporary acute hospital to relocate patients from Mount Carmel had failed, but it acknowledged efforts to make Mount Carmel Hospital safer and better suited for mental health patients.

Health Minister Chris Fearne said earlier this week that while extensive works were underway to refurbish the hospital, acute services would eventually be transferred to a new facility for which land has been allocated near Mater Dei Hospital. 

The audit office said he had also observed progress regarding Mount Carmel Hospital security personnel but not much had been done to improve the hospital’s CCTV systems and the management of master keys.

The audit office welcomed an increase in recurrent and capital financial allocations for the hospital between 2018 and 2022, as well as a reduction in staff shortages, even if the current situation was still not optimal as the hospital faces significant challenges to recruit staff. 

"The launching of a mental health strategy, and the Mental Health Service's evident accomplishment to drastically reduce the number of in-patients at Mount Carmel Hospital who do not strictly require hospitalisation in a mental health institution, was also positively noted in this review," the audit office said.

"This ties in with the significant effort which has been invested in the strengthening of community services by the Mental Health Service, most notably insofar as human resources (even if the ideal complements still must be reached) as well as communication between community clinics/centres and central MCH are concerned."

Still, the office said it remained concerned about the challenges being faced by community services which are housed in premises which are either inadequate or too small to suitably cater for mental health out-patients.