Meeting documents

Mr M Tett

The Chairman, Martin Tett welcomed everybody to the first themed meeting looking at the priorities of the refreshed Joint Health and Wellbeing Strategy and emphasised the importance of the mental health and wellbeing agenda at both a local and national level.

The Chairman provided context to the meeting by highlighting the Mental Health Five Year Forward View published in 2016 which had put forward a consensus on what needs to change and more recently the Prime Minister, Theresa May, had made her first speech in 2017 outlining plans on how the government was going to tackle mental illness and transform attitudes to mental health problems. It was also announced that the government would be publishing a green paper on children and young people’s mental health and wellbeing later in the year. The Chairman confirmed that the Health and Wellbeing Board would focus on Children and Young People’s mental health at a future meeting in 2017 to coincide with the publication of the green paper which is why the meeting today was largely focused on adults.

Given the high profile of NHS pressures in the national media, the Chairman invited, David Williams of Buckinghamshire Healthcare Trust (BHT) to provide the board members with a short update on the situation at BHT before the themed meeting started.

David Williams said that the Trust were doing all they could to make sure all patients received care in the right place at the right time but there were clear pressures over the winter months. On average, throughout the year 95% of patients at BHT are seen within a 4 hour waiting time but during winter months this was around 86%. Nationally the figure is 80% (BHT is operating comparatively at a level of 25 out of 150 Trusts nationally). Work is on-going with partners to speed up delayed transfers of care to free up available beds on wards and this issue was monitored on a daily basis. 

Dr Jane O’Grady

Summary:

·         Mental health is a Joint health and Wellbeing Strategy priority

·         The foundations for good mental health and wellbeing happen in the earliest years  

·         People from all walks of life are affected but risks are higher for those living in poorer social circumstances, experiencing stressful or traumatic events marginalised groups and those having other illnesses

·         Largest single cause of disability in UK costing £105bn and set to rise

·         Substance and alcohol misuse – strong determinants of poor mental health

·         Best buys for supporting mental health include supporting parents, early years, workplace-based programmes, supporting changes in lifestyle behaviours as well as improvements to the built environment and public spaces

Presentation

"Promoting good mental health to those who are vulnerable to poor mental health:

To include

·         20 minute presentation

·         10 minute Discussion

Presentation led by Dr Sian Roberts Mental Health and Learning Disability Clinical Director, CCGS.

Dr Sian Roberts, Clinical Director Mental Health, Learning Disabilities and Dementia (Chiltern and Aylesbury Vale Clinical Commissioning Groups) took Board Members through her presentation.

Summary

·         Mental Health is everybody’s business and needs a partnership approach

·         £40million spend on mental health in Bucks

·         75% of people with mental ill health don’t present to a health organisation

·         4000 people in Bucks going through Improving Access to Psychological Therapies Programme (IAPT) with a 50% recovery rate = 15% of the estimated 1 in 4 people in Bucks deemed to have mental health issues. National target is 25% by 2020/21.

·         Year on year more adults in Bucks recovering from depression & anxiety

 with pathways that treats the ‘whole person’ – body and mind

·         The presentation covered the CCG Mental Health Plans, including improving Urgent Mental Health Care, Expanding and increasing access to IAPT services and improving the transitions from CAMHS to Adult Mental Health Services. 

 Discussion points:

-       Support from Health and Wellbeing Board members for a holistic approach and taking forward the NHS five year forward view ambition for parity of esteem

-       Recognition that the pathways and number of services are complex and work to be carried out on information provided to the public to increase accessibility and awareness of the services and resources available

-       Consensus that the Health and Wellbeing Board should be leading on promoting common messages

-       To note: launch of Buckinghamshire Recovery College on Friday 27 January .

A Directory of Services will soon to be available in Buckinghamshire

Presentation: Work Place Health

Covering the Joint Health and Wellbeing Strategy Aim

"We will promote adult wellbeing and resilience in all partner work places as part of wider workplace health initiatives"

To include an update from all HWB organisations on their actions to promote adult wellbeing and resilience in the workplace

To include: 

-       What are we doing as employers? (update from OHT,CCGs and BCC)

What could we do as a HWB together to encourage mental health awareness in the work place?

Presentation led by Karon Hart, Healthier Lifestyles and Staff Wellbeing Manager at Buckinghamshire Healthcare Trust.

Karon Hart, Healthier Lifestyles and Staff Wellbeing Services Manager, took Board Members through her presentation.  Presentation attached.

Summary:

·         Persistently high levels of sickness absence at cost to both individuals and the organisation led to a change of interventions to promote staff health and wellbeing

·         Staff are empowered to look after their own health and wellbeing which in turn benefits patient care

·         The BHT resilience programme includes lots of group work, increasing the understanding of stress and building resilience, work/life balance and coping strategies. Managers had previously been trained in ‘difficult discussions’ now trained in ‘essential discussions’ and wellbeing is a core part of the appraisal process

·         Managers are enabled to deal effectively with staff wellbeing and sickness absence through robust case management 

·         Strong evidence that wellbeing can impact positively on all aspects of business functioning

Discussion points

-       Members of the Health and Wellbeing Board were keen to understand what their own organisations were doing to promote mental health and wellbeing in the work place and committed to sharing good practice. 

-       Board members discussed the role of mental health champions and would like further information on this.

-       It was also raised that small/medium sized enterprises and self-employed businesses should be included and suggested that this could be explored through Bucks Business First.

Presentation on suicide prevention:

Covering the JHWBS action to

·         Implement plans to reduce the risk of suicide

To include:

·         20 minute presentation

10 minute discussion

Presentation led by Rebecca Hitch,Public Health Practitioner, Buckinghamshire County Council

Becky Hitch, Public Health Principal, took Board Members through her presentation.  Presentation is attached.

Summary:

·         Suicide rates are rising. It is the biggest killer of men under 49 and also the leading cause of death among new mothers.

·         There are between 30-38 suicides in Buckinghamshire every year

·         Around 1 in 3 people who die by suicide are known to mental health services

·         34% of those who had taken their own life in Buckinghamshire in 2013/14 had consulted a GP for mental health problems in the last 12 months.

·         Recognition that more needs to be done to build on partnership working already taking place across Thames Valley.

·         Thames Valley Police have a real time suicide surveillance system and a Suicide and Intervention Network led by Oxford Healtcare NHS Foundation Trust.

·         The Buckinghamshire Suicide Prevention Group are currently refreshing the county wide suicide prevention strategy and have made a number of recommendations shared in the slide pack which are aimed at specific vulnerable groups as well as calling for a stronger partnership approach to reduce stigma and shared messages, including promotion of the Headsup website http://thisisheadsup.org/.

Discussion points:

-       The Health and Wellbeing Board listened to the experiences of Robert Stringer at Hector’s House and Geoff Price at Survivors of Bereavement by Suicide who had both personally been affected by suicide and were carrying out important work to improve public awareness and provide support.

-       There was a commitment from the Health and Wellbeing Board to do more on suicide prevention and positive support for emerging national guidelines which are yet to be formalised including; Mandatory support to those bereaved by suicide, Training for frontline staff and Funding to cover GPs to attend training.  

-       Board members commented that there was lots of information but not joined up messaging or clear pathways and this was an area to be strengthened across the partnership.

·         Reflections on today’s presentation and discussions

·         Where are the gaps?

·         What can the Health and Wellbeing Board do?

·         Next steps 

All – Chaired by Mr M Tett

Overall summary of the themed meeting:

·         A suggestion that as lead commissioners there should be a set of guidelines for mental health and wellbeing in a central repository and this should be carried out in a way that uses existing resources more effectively.

·         There was appetite for joined up positive mental health campaigns across the county

·         Commitment from members to make sure mental health and wellbeing information is available on their organisation websites (e.g. promotion of the Heads up website)

·         Commitment to improve mental health and wellbeing in the work place, share good practice and report back on what each organisation was doing and planning to do

·         It was suggested that the Board needed a better understanding of the role of mental health champions and how they could work.

·         It was suggested that all members on the Health and Wellbeing Board report back on what they are going to do as an organisation to promote mental health and what they can offer

·         To note that Healthwatch are due to publish their report on peer support in mental health in partnership with Mind and will share this with Board members.

1.    For Action:  All members to report back to Katie McDonald on what they are going to do as an organisation to promote mental health and wellbeing and what they can offer both in the work place and in the way of improving communication and access to services

2.    For Action: Katie McDonald with public health colleagues and feedback from Health and Wellbeing Board members to take the issues raised at the meeting to draft a short report as follow up to set out priorities and actions for agreement by the Health and Wellbeing Board at the next meeting on 9 March 2017.

3.    For Action: All members to feedback to Katie McDonald on proposals for themed meetings for 2017/2018

A number of websites and resources were mentioned throughout the meeting and these can be found here:

http://www.healthwatchbucks.co.uk/service-guide/mentalhealth/

https://www.nhs.uk/Livewell/Suicide/Documents/Help%20is%20at%20Hand.pdf

http://www.bucksmind.org.uk/

http://thisisheadsup.org/

http://www.hectorshouse.org.uk/

http://uk-sobs.org.uk/