Mental Health Topic Group - Hertfordshire



JOINT COMMISSIONING PARTNERSHIP BOARD

THURSDAY 7 MAY 2009 AT 10 A.M.

MENTAL HEALTH TOPIC GROUP

Authors: Mark Jordan, Head of Joint Commissioning

Tel: 01438 843232

1. Purpose of report

To present the recommendations of the Hertfordshire Health Scrutiny Committee (HSC) Mental Health Topic Group and partners responses.

2. Summary

The Hertfordshire Health Scrutiny Committee formed a Mental Health Topic Group in autumn 2008 to address the following questions

← How are access issues being addressed (including travel distance, appointments, services)?

← How does the implementation plan ensure co-ordination of services between Trusts and primary care etc?

← How does the implementation plan address equalities issues, in particular equality of provision across the County?

← How has the patient experience been built into the Plan? (What are the Trusts doing to ensure they meet the Department of Health directive on the patient experience? How are they obtaining information about the patient experience? What is done with this information to ensure patient experience is improved? etc.)

← Is the infra-structure sufficiently robust to support the implementation (IT, patient records transfer, staffing (including administrative staff), duality of infra-structure, communication strategy for public and staff etc)?

← What will be the impact of the Health Authority proposals – ‘Towards the best, together’?

The group took evidence from a range of sources and presented its findings and recommendations to the scrutiny committee in March 2009.

Its conclusions were as follows

← The previous scrutiny of mental health made a number of recommendations. From the evidence received during this investigation it was concluded that commissioners and providers have taken significant steps to address these concerns. The Group were assured that long term solutions were being developed which would, as far as possible, safeguard services against future budgetary pressures.

← It is unclear what the impact of the Mental Health Act will be on compulsory treatment in the community or to what extent an upward trend is a consequence of the Act. The Group were assured that resources are being made available to address needs. This is an area that the Group expect the JCPB Board and JCT to monitor.

← Offenders are often an overlooked group when discussing health in a community. The HSC may wish to consider the health needs of offenders for its future work programme.

← There was discussion on direct payments and personal health budgets, and the need for commissioners to have a clear understanding on the cost of an individual’s care, including the cost of housing support. JCT have agreed that it will bear this in mind when finalising the Accommodation Strategy.

← Concern remain at the robustness of the infra structure (training, IT, communications) to deliver the full benefits of the community based mental health services.

In presenting its report to scrutiny partners were asked to provide a response to the report’s recommendations. In their response partners welcomed the report and recommendations as both helpful and realistic and providing a key steer for the Investing In Your Mental Health (IIYMH) Implementation Programme saying that the programme and partnership boards would therefore oversee progress on the recommendations. Partners noted that they would welcome any future work of the Health Scrutiny in topics related to the work of the partnership.

3. Background Information

The full report of the topic group is available upon request or via the Herts Direct website.

Below are listed the report’s recommendations and partners’ responses with regard to outcomes and future actions.

|Recommendations: |Outcomes/Further Action: |

|That the IIYMH Review Implementation Group and Joint |The recommendations of the topic group will be presented at May 2009 JCPB and from |

|Commissioning Team monitor the recommendations made by |there be integrated into the Investing In Your Mental Health Programme Plan so that |

|this Group and report on progress to JCPB and HSC |progress can be monitored through both these structures. A programme director has been|

|regularly during 2009, including monitoring the impact of |appointed for Investing In Your Mental Health and is expected to start in post later |

|any future pressures on public spending, especially after |in the spring. |

|2010. |The monitoring of pressures on public spending should be a routine consideration of |

| |the Joint Commissioning Partnership Board and their advice will be sought on how they |

| |would like this to be approached. |

|That during 2009 ACS and its partners ensure that the |It has been proposed by commissioning partners that the Joint Commissioning Team |

|whole needs of older people are addressed, including |coordinate a joint review of arrangements for the commissioning and provision of |

|physical and mental health needs, alongside social care |mental health services for older people. Such a review will need to be accountable to |

|requirements. This needs to include a review of the age |the JCPB and strategic commissioning group and structured and conducted as a formal |

|parameters of the contract with Viewpoint when gathering |focussed project. The agreement and undertaking of this project will need to take |

|the views and identifying the needs of older users. JCT |place with the participation of all stakeholders including current and potential |

|to ensure that this informs service design and delivery. |providers. Arrangements for this review will be presented to JCPB for approval. |

| |Joint Commissioners will report to JCPB later this year on progress regarding user / |

| |carer involvement in the commissioning of older people’s mental health services |

|That involvement of users/carers continues to be developed|This remains a key strategic element of all aspects the Joint Commissioning |

|in both the strategic formation of plans and their |Partnership. Structures are being further developed including from April 2009 revised |

|implementation over 2009 |approaches to public meetings and user / carer engagement. |

|That the Implementation Group urgently addresses pressures|A number of operational / management actions are already being taken by Hertfordshire |

|on acute beds by significantly improving services around |Partnership Foundation Trust and further investment proposals relating to this will be|

|acute admission as reflected in Recommendation 2 of the |presented to JCPB in May including both bed based services and alternative community |

|IIYMH Stocktake that: Subject to the availability of |services. |

|resources, apply new investment available for services of |Commissioners will also continue to monitor and address any performance issues |

|adults of working age to the development of crisis beds |regarding those community services that affect the effectiveness of inpatient |

|(as alternatives to admission), additional crisis and home|services. |

|treatment services, and higher-staffed supported | |

|accommodation. | |

|That JCT maintains and develops investment in ward |Interim investment (£500k pa) in this has taken place regarding this and when long |

|therapies and activities beyond NHS and medical-led |term investment plans are drawn up during 2010 this recommendation will be taken into |

|provision |account by partners. |

|That during 2009 JCT review and develop support for |Multi-agency structures are in place supporting a number of county wide initiatives to|

|offenders taking into account work undertaken by HCC’s |address the needs of offenders who have mental health problems or learning |

|Money Advice Unit concerning offenders and the economic |disabilities both currently and in anticipation of future social and economic |

|downturn |pressures. Investment proposals regarding community forensic services and prison |

| |‘outreach’ services will be presented at May 2009 JCPB with the intention of further |

| |strengthening resources and structures to meet these needs. Joint Commissioning work |

| |on Employment and Social Enterprise development is also being designed to address and |

| |'mainstream' these issues. It should be noted too that the Herts Criminal Justice |

| |Board has also committed to providing significant support to help establish county |

| |wide panels for Mentally Disordered Offenders to help coordinate this work. |

| |The effectiveness of the Joint Commissioning Partnership's work in this area will be |

| |further enhanced if also Hertfordshire Forward can shape the Local Area Agreement and |

| |Community Strategy to address such 'cross-cutting' challenges. |

|That the Implementation Group takes into account the |See 1 above. A proposed programme plan and programme management structure for primary |

|recommendations made here and by the previous scrutiny of |care developments will be presented to the implementation group in April which if |

|mental health, especially in regard to the infrastructure |successful will be expanded to incorporate all aspects of the Investing In Your Mental|

|to support implementation |Health Implementation Programme. |

4. Recommendations

The Joint Commissioning Partnership Board are asked to note the findings and recommendations of the Topic Group and agree that:

a) The appropriate actions are underway to address these recommendations.

b) The Board will continue to monitor the implementation of these recommendations.[pic][pic]

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Agenda Item No.

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