Agenda item

Attending for this Item were:

Herefordshire and Worcestershire Clinical Commissioning Group (HWCCG)

Jenny Dalloway, Lead for Mental Health, Learning Disabilities and Children

Dr Tim Lee, Mental Health GP Lead

Herefordshire and Worcestershire Health and Care NHS Trust (HWHCT)

Sue Harris, Director of Strategy and Partnerships

Emma Webber, Associate Director of Specialist Mental Health Services

Jayne Westwood, Service Manager – Older Adult Mental Health

Worcestershire County Council (the Council)

Dr Kathryn Cobain, Director of Public Health

Kerry McCrossan, Assistant Director of Adult Social Care

Cllr Karen May, Cabinet Member with Responsibility for Health and Wellbeing

The Health Overview and Scrutiny Committee (HOSC) had received a Report and Presentation Slides as part of the Agenda.  Members were guided through the detail by those present, with the following key points being made:

·         Mental Health services was a broad provision, covering all ages and a range of providers, including GPs, specialist services and the voluntary and community sector

·         Throughout the COVID-19 pandemic, mental health services continued to be provided, albeit with changes to provision to manage infection control

·         Services had been generally place based, however, with the inception of Primary Care Networks, there had been a shift in delivery options available and work with schools and the Police was increasing

·         Health economy partners were working to develop a new Mental Health Strategy, which was to be discussed at the Health and Wellbeing Board in late September and would be shared with the Committee in due course

·         The voluntary sector had a key role to play in localities, especially with the increase in social prescribing

·         Members learned of the range of services available for Child and Adolescent Mental Health Services (CAMHS), Adult Mental Health Services and Older Adult Mental Health Services

·         During the pandemic there had been pressure nationally on CAMHS Tier 4 beds, however, crisis support had been expanded to try and avoid admissions

·         The NHS Long Term Plan focussed on providing crisis support 24 hours a day, 7 days a week for patients experiencing an acute mental health crisis.  This had been achieved and additional funding had also been secured to expand A&E liaison

·         Within Worcestershire, there were 41 Adult inpatient beds, including an Intensive Care Unit, however, some patients required out of County placements

·         For Older Adults, there were 30 inpatient beds.  Capacity was managed well to avoid any out of County placements

·         The Mental Health Social Work Team had been run by the Council since April 2021 and continued to support the same number of people as previously.  Recruitment of front line professionals had been successful and investment in this area would continue

·         The Council promoted the 3 Conversation approach to social care

·         In relation to Public Health, the full impact of the COVID-19 pandemic on mental health was unknown, however, early indications suggested that although there had been a decline in average mental health it was an improving picture.  The impact of Long Covid was currently unknown.  The Mental Health Needs Assessment, when available, would be shared with the Committee

·         The Health and Wellbeing Board was committed to prioritising mental health

·         Nationally, workforce was an issue across the sector, however, it was important for the NHS to continue to rise to the challenge and embrace the opportunities locally

During the discussion, the following main points were raised:

·         A Member was interested to know what support was available for Armed Forces veterans and learned that organisations were mindful of specialised need.  Provision was in place for veteran specific requirements and good practice from Herefordshire had been shared with Worcestershire colleagues

·         The Mental Health in Schools programme was a new initiative with new Staff.  The team would be working with a number of schools, with specific details provided to Members when known.  It was hoped in time that all schools would benefit from the provision, however, nationally funding was the constraint.  The selection was not geographically based and no area was disadvantaged.  For clarity, the Education Psychiatrist Team was unaffected by the new programme

·         When asked whether the use of social media or the internet was of concern to mental health professionals, Members were told that it was an issue and of concern nationally.  There was good awareness amongst professionals, especially those working with young people and if criminal activity was known, it was reported to the Police, for example, instances of online grooming

·         The different methods of delivering sessions, such as face to face, telephone or video all had a place, likewise with individual or group sessions.  Members were interested to know the breakdown of appointment type and acknowledged that all methods were relevant and of value

·         Continuity of care from children to adult services was important to achieve good outcomes for the individual.  Discussions were taking place as to whether transition should be raised from 18 to 25 to ensure a smoother pathway

·         Although different organisations had their own structure, mental health was delivered through a partnership approach and would be more seamless when the Integrated Care System was fully in place.  There was much more collaboration now across the health and social care system

·         There was dedicated support for children looked after by the local authority, with a growing understanding of the effect of adverse childhood experiences on mental health

·         Waiting Times for services were collected and would be shared with Members in order to understand the different requirements of residents

·         It was suggested that Dementia was an upcoming concern for public health.  If a patient had mental capacity and did not agree to receive help, the patient may well hit crisis point before support was initiated

·         The HOSC heard that the voluntary sector was invaluable to the support available for mental health

·         In response to a question as to whether some people of a working age used mental health as an excuse to be signed off from work, the Committee was advised that the wider question was the attitude to mental health as a nation.  The stigma attached to mental health needed to change, with acceptance that some low mood days were part of normal life events and strategies were available to make life easier

·         Feedback from patients was mainly positive across the range of services provided.

The Managing Director of Healthwatch referred HOSC to two reports which they had published early in 2021 covering the topics discussed.

The HOSC Chairman thanked everyone present and asked for areas of future HOSC focus.  It was agreed to include Dementia, preventative measures, including perinatal, and children and young people on the Work Programme.