Meeting documents

Mental Health is a key priority for the Health & Wellbeing Board and is high on the agenda for many health organisations so this item is an opportunity for Members to hear from representatives from Oxford Health and Adult Social Care about delivering mental health services across the County.

Attendees:

Lin Hazell, Cabinet Member for Health & Wellbeing

Ms G Quinton, Executive Director, Communities, Health & Adult Social Care

Ms S Westhead, Interim Service Director (Operations), Adult Social Care

Ms S Robinson, Head of Service, Buckinghamshire Adult Mental Health

Papers:

Report attached

Intended outcomes:

For Members to seek reassurance about the County’s mental health services and to hear from health and social care professionals about the challenges facing them and their plans for meeting future demand on the service.

The Chairman invited Committee Member, Julia Wassell to lead this item due to her experience in this area.  She welcomed Lin Hazell, Cabinet Member for Health & Wellbeing, Ms S Westhead, Interim Service Director (Operations) and Mrs S Robinson, Head of Service, Buckinghamshire Adult Mental Health.

During the presentation, the following main points were made:-

·         Buckinghamshire’s Mental Health Care was provided by Oxford Health NHS Foundation Trust supported by the County Council through a S75 agreement which had been in place since 2007.

·         The Clinical Commissioning Groups had allocated £40m to Oxford Health and the County Council contributed £3.7m for the social care costs associated with mental health services.

·         The Whiteleaf Centre in Aylesbury was the base for the Adult Mental Health team who support patients in the community.  Whiteleaf was also where inpatient services were located.

·         The Integrated Care System had created opportunities for further integration work.

·         A bid had been submitted for additional funding to support the peri-natal service for patients displaying mental health issues, before, during and after pregnancy.

·         The Psychiatric in-reach and liaison service (PIRLS), based at Stoke Mandeville Hospital, provided wrap around care for patients who were initially being treated for physical health problems but who also displayed mental health conditions such as depression, dementia or delirium.

·         During 2017, there were two safeguarding adults reviews and as a result, Oxford Health was piloting a senior mental health nurse working within the MASH (Multi-Agency Safeguarding Hub) with the Police and County Council staff.  The pilot would be evaluated after 3 months.

In response to questions from Members, the following key points were made:-

·         There was a Physical Health Action plan which included CQUIN targets set by the Clinical Commissioning Groups which aimed to achieve parity of esteem.

·         It was noted that those suffering from mental health issues had their mortality rate reduced by 20 years.

·         As part of the contract monitoring, the dashboard performance data would be reviewing parity of esteem.  It was acknowledged that there was currently no benchmark data around parity of esteem and it was still early days in achieving it.

·         The additional funding made available by the Government was already in the baseline budget and Oxford Health was working with the Clinical Commissioning Groups to identify priority areas.

·         Self-neglect was a priority and Bucks Adult Safeguarding had developed an Improvement Plan around this.

·         In response to a question about the overarching vision for mental health and how the initiatives were working together to achieve the vision, Ms Westhead recognised the need to join-up the vision for mental health with adult social care.  Oxford Health was working with the Clinical Commissioning Group to focus on outcomes and to better understand what the data was showing in order to measure the effectiveness of the interventions.  This was work in progress and it was agreed that comparative data would be presented to the Select Committee in due course.

·         It was acknowledged that there was more work to do around transitions from the Children’s Mental Health Service to the Adult’s Service.  The services were very different which could lead to very different experiences.  Discussions were ongoing around whether to review the transition age.  It was acknowledged that there needed to be better interface between the services.  The vision was for an "all age" service which would help to reduce the duplication in having to "tell your story more than once".

·         A clinical audit was currently being carried out to ascertain what kind of service was required to try and assist with the current recruitment problem.

·         Harlow Valley Centre Day Hospital was confirmed as being temporarily closed due to staff shortages but as soon as the staff had been recruited, it would be re-opened.

·         Vacancies were reported across all areas but there was a particular challenge in the South of the County.  Oxford Health’s Chief Executive was lobbying for a range of higher weighted wages for the area to help with the recruitment challenges.  The Trust was looking at this issue across Oxfordshire and Buckinghamshire and reviewing flexible ways of working to meet the recruitment gaps.

·         It was reported that there were 4 Wards with 20 beds each at the Whiteleaf Centre and bed occupancy was over 100% as some patients were out on extended leave.

The Committee asked to receive further information on the following:

·         A breakdown of the mental health budget and how it was spent across the different services.

·         Charts to illustrate the success of interventions.

·         A copy of the Bucks Adult Safeguarding Improvement Plan.

·         A breakdown of Community Treatment Orders, by location, age, ethnicity and timeframe.

·         More analytical data to enable the Committee to compare and contrast the mental health services.

Action: Oxford Health in conjunction with partners