Agenda item

Attending for this Item from Worcestershire Health and Care Trust were:

Sue Harris, Director of Strategy and Business Development

Stephen Collman, Director of Operations

Zelda Peters, Adult Mental Health & Learning Disabilities Transformation Lead

Dr Jan Birtle, Clinical Director (Adult Mental Health)

Jenny Dalloway, Lead Commissioner (Adult Mental Health and Dementia)

By way of presentation, the Director of Strategy and Business Development and the Director of Operations provided the Committee with an update in relation to Adult Mental Health transformation.

Budgets were reducing and in 2016/17, this was by 7.5%.  Demand and expectation was rising and it was proven that early intervention and prevention had a positive impact on individuals.  In addition, options for self care and recovery needed widening.  It was clear that in order to achieve these goals, there was a need to think differently and work together with partners.

Worcestershire Healthy Minds was a package of services which had been redesigned to provide easier and quicker access to assessment and treatment.  It enabled new ways of working across General Practice and the voluntary and community sector and allowed self-referral to Talking Therapies - the first time for Mental Health.  Being part of the Wellbeing Hub and accessible by internet and app, it provided County wide coverage and increased options locally depending on what communities were interested in.    

The Wellbeing Hub was the link to mental health support in the County, providing information and signposting for anyone over the age of 16 who was experiencing low mood, stress or anxiety.  Managed by Community First, the website was instantly available and telephone callers would be assisted between 9am and 5pm Monday to Friday.  There was the ability to self-refer to a range of Talking Therapies and the Wellbeing Hub provided a seamless transition to secondary care where needed.  Whilst promotion of the service was ongoing, it was noted that 302 contacts already existed, with the Redditch area being most represented at present.

The use of technology in self-help and signposting was increasing over time and for the three month period ending 30 June 2016, the Worcestershire Healthy Minds webpages had 6,600 hits.  In addition, a mobile app which had recently been developed was due to be launched soon.

In relation to Secondary Care redesign, the Committee was reminded that there were 3 elements to consider:

·         Community Mental Health Services

·         Acute Inpatient Wards

·         Home Treatment Service

There also needed to be consideration of whether services were clinically effective, safe, compliant with quality of care standards and were meeting commissioner and patient expectations.

The redesign was co-produced with stakeholders, including patients, staff and others, and engagement was wide, including presentations at HOSC throughout 2015/16.  There were numerous forums and meetings to ensure the model was sustainable.

From the engagement undertaken, there had been five recurring themes:

·         The need to reduce and centralise inpatient acute wards

·         The wards to have a clear function, mainly intensive triage and treatment for the acutely mentally ill

·         A requirement for alternative provision in the form of safe houses or crisis beds, enabling focussed step down

·         Increased and improved home treatment to care for more people in their own home

·         To have specialist community mental health teams with a clear function to provide services to patients with serious mental illness

In addition, patients and carers had been clear about what matters most to them, including consistent staff who had time to listen, care and involve patients and carers, information along the journey and inpatient wards that offer activities and calm spaces for only those that really need them.

In relation to Community Mental Health Teams, a specialist Community Assessment & Recovery Service (CARS) was proposed which would be developed following national guidance.

For Inpatient Wards, there was a proposal to have an intensive assessment ward with 7 day admission, aligned with a separate treatment ward.  This proposal of separate wards was as a result of listening to patients who asked for separate wards to avoid very unwell patients mixing with those recovering and about to go home.  This proposal could also only be developed if alternatives to admission, such as supported living, were explored.  It was also seen as best practice nationally.

Members were informed that the next step would be to commence formal public consultation and as a result of feedback, further remodelling may be required.  Presentations would be held across the County, events would be attended and a media presence was planned.

It was hoped that the new model would be implemented by December 2016.

In the ensuing discussion, the following key points were raised:

·         One Member enquired about the transition from mental health services for children to adult services, to be informed that Worcestershire Healthy Minds was available from the age of 16 and clinical conversations were ongoing.  Young people were at risk of being labelled, which could potentially affect their self esteem

·         When asked whether mental health nurses were available in all GP surgeries, it was clarified that this was not the case as there were different commissioning models throughout the County

·         In relation to a question about remuneration, Members learned that payment was not by results, however, there was a move nationally to move towards this model.  Instead, the principle was to work in collaboration with partners for the best outcome for individual patients and this may equate to working in a different way

·         Members were asked to consider and promote the consultation in their local areas and also the Wellbeing Hub, in particular the Worcestershire Healthy Minds programme, accessible via this link click here

The Chairman thanked those present for an useful discussion and asked for an update following the consultation period.