Agenda item

To receive an update from the Midlands Partnership Foundation Trust’s Head of Primary Care Development & MH Programme Lead (South Staffordshire)

The Vice-Chair welcomed the Assistant Director, Partnerships Jo Sands, Mr Upkar Jheeta, the Midlands Partnership Foundation Trust’s (MPFT) Head of Primary Care Development & MH Programme Lead (South Staffordshire) and Susan Unwin (Consultant Nurse and Approved Clinician at MPFT) to the meeting.  The representative from MPFT took the Committee through a presentation, and video, which covered:

1.    Current configuration of adult mental health services

2.    The Model of the Community Mental Health Framework

3.    Crisis Alternatives; to provide alternatives to inpatient facilities, including a Crisis Café and in conjunction with that a broader crisis response through the voluntary sector to support patients in their own homes.

4.    Core 24, which is co-located with Accident & Emergency services

5.    Winter discharge and Hospital avoidance, to support patients leaving hospital or prevent an admission to hospital, where interventions include deep cleaning, carrying out repairs, supporting with utilities and food, which had been delivered in partnership with voluntary organisations and the hospital avoidance service was supplemented with a wellbeing adviser and housing adviser

6.    Improving Access to Psychological Therapies (IAPT), where patients can refer themselves and the service is delivered with a range of partner organisations, and includes an integrated bereavement service.

7.    Additional mental health developments, including encouraging physical healthchecks.

The Committee commented and sought clarifications in the following areas:

·         Whether the services were facing workforce challenges and the impact of that on these services and how this was being addressed, where it was reported that the way the services were being delivered involved working with the voluntary sector.  It was reported that nationally there was a requirement to ring fence 20% of the investment to the voluntary sector however, MPFT had decided to significantly increase the proportion of activities delivered by the voluntary sector and the total contract value to the voluntary sector was in excess of £2.5million and this had enabled MPFT to bring their vacancy rate down from 27% to 13% and MPFT were continually looking at new contemporary workforce to help deliver the transformation and MPFT were working closely with Keele University regarding clinical associate psychologists to address areas of national shortages in occupations.

·         The nature of the 4 week waiting time standard and whether the standard from a patient’s referral to the service to the completion of a trusted assessment and the start of an intervention was a national standard and whether MPFT aspired to have a shorter period.  The Head of Primary Care Development reported that it was a national standard and that to determine whether or not this target was being achieved required MPFT to have the correct metrics in place to measure these and they were required to have those metrics in place by the end of this financial year.  Following that MPFT it would be MPFT’s aspiration to do better than that and to deliver interventions as quickly as possible, and early interventions may be more holistic interventions.

·         Whether evidence of the improvements in the service’s performance could be shared, where it was reported that these could be shared, although the data was on a county level. 

·         Whether the suggestions to bring a Crisis Café to Tamworth was driven by evidence of the need in Tamworth where it was reported that there was no Crisis Café in South Staffordshire and to ensure equity of access MPFT had put forward a business case which had been approved by the NHS England Improvement and the capital investment would take place in Tamworth as that was where the need was.  There was then the need to look at whether complementary services to the Crisis Café which could be brought together to enhance the provision would be brought to Tamworth and this would be determined by a needs assessment.  These services would be accessible by the whole of the South Staffordshire population.

·         How many practionners had MPFT got working in primary care in Tamworth?  It was reported that it was a decision of the Primary Care Network (PCN) to agree to have a mental health practionner and the Tamworth PCN had opted out, and accordingly whilst discussions continued with the Tamworth PCN MPFT had supplemented the provision with alternatives to look to address this inequality as MPFT had seen areas where this provision had worked effectively to reduce demand for secondary care, reduced waiting times for interventions.

·         How MPFT would ensure that the need for repeat conversations across the varied services available was minimised, where it was reported that all MPFT commissioned partners would have access to common systems to minimise the risk of that.

·         The accessibility of the services by the deaf / blind community or by those from under represented groups.  It was reported that detailed population analysis had been undertaken at the start of the transformation which had helped establish the priority groups and there were also community grants available.

·         The arrangements for winter discharge and whether there were visits to the patient’s property prior to discharge.  It was reported that where this was possible it would take place, and there was a national requirement for the recovery worker to visit within 48 hours of discharge and MPFT had brought that timescale down to within 24 hours of discharge.

·         Whether MPFT were familiar with the local charities within Tamworth working in the mental health area, where it was reported that MPFT worked and had commissioned services from charities and would consider charities as part of the community foundation grants scheme.

·         Whether there were any specific mental health crisis teams for older people / people with dementia.  It was reported that nationally Crisis Resolution was commissioned for people with dementia, however MPFT did have a hospital avoidance team to help people with dementia.  In South Staffordshire the crisis team was an all age adult provision, however, it was acknowledged that the provision for older adults would need enhancement, with specific skills with older adults.

·         Regarding buildings which could be used for community mental health services, where it was reported that MPFT had decided to bring Cherry Orchard back online for community provision with the first phase of services to start from March 2023, with a second phase of additional activity once the extension was completed from September 2023.

·         Whether this service covered Children and young adults mental health services as well, where it was reported that this was for adult services, and young adults would be a separate pathway as normally adult and children’s services would not be delivered in the same building, unless there was a separate entrance for children and young adults with it’s own waiting areas in line with Mental Health building standards.

·         How the organisation was prepared for the cost of living crisis.  It was reported that part of MPFT’s winter plan was to work with the Borough Council’s to support warm places.

·         How the delivery of hospital avoidance services was delivered, where it was reported that there was a range of delivery methods used.

The Committee thanked the Head of Primary Care Development & MH Programme Lead and the Consultant Nurse and Approved Clinician from MPFT for their attendance, who then left the meeting.