Agenda item

The Panel will receive a presentation on this item.

The Chair invited Nicola Hazle (Avon and Wiltshire Mental Health Partnership), Jane Rowland (BSW CCG) and Kate Morton (Bath Mind) to address the Panel.

Jane Rowland said that they would like to discuss with the Panel the way in which services across B&NES were transforming, gain their views on the approach that has been taken so far and hear any thoughts relating to future plans. She added that it was important to recognise the mental health needs of people post Covid.

Aligning priorities – MH and BSW Model of Care

·  Working together to empower people to lead their best life

o  Starting well

o  Living well

o  Ageing well

·  Personalised care – We want health and care to be right for every individual – not ‘one size fits all’

·  Healthier communities – We want people to live in communities that help them to live healthier lives

·  Joined-up local teams – People from the NHS, local authority, third sector and other partners will form teams together and we will have the right teams in your area

·  Local specialist services – We will provide more access to routine appointments, tests and treatments closer to where you live

·  Specialist centres – Our specialist centres like hospitals will focus less on routine care and more on specialist health and care.

Using digital by default

We will make full use of digital technology and data to improve health and care for people in BSW. We will also make sure that all our teams and services are inclusive for people with limited access to technology.

BSW System: Mental Health Priorities

·  Eating disorders – numbers are on the increase

·  16 – 25 years old – What provision is available through the transition into adulthood?

·  Personality disorders – Emotional trauma that has affected an individual. Sometimes referred to as Complex Emotional Needs

·  Older person services

·  Crisis services – Align with ambulance service and 111

·  Perinatal Mental Health

·  Neurodevelopment / ADHD

Where are we now…….

• Continued need to improve access and referral process – make getting support easier. Integrated approach with third sector and AWP

• Mental Health referrals above pre-Covid levels

• Increase in emotional wellbeing presentations. Increased anxiety in communities –including parental and family anxiety. Impact of wider determinants of Mental Health (e,g, housing, employment, family breakdown, bereavement, returning to school and current financial crisis)

• Priority focus on reduction on Out of Area Placements - a collaborative system response in progress

• Workforce risks – recruitment, retention and sickness. Impact on staff through Covid response and recovery

• Growing trust and confidence between statutory and third sector partners as we develop a different delivery model of care

• Understanding what people, families and staff have thought of the changes we have made and where we need to focus – regular engagement and co-production

B&NES: Key Themes

Nicola Hazle explained to the Panel some of the challenges and what will be seen as different in terms of provision.

High demand across the community services

•  New access model where first contact is community not clinical

•  Improved access to specialist input and/or advice and guidance via digital platform (indirect improved experience for people)

•  Focus on quicker access to intervention rather than assessment via evidence based care pathways

Greater complexity and acuity in presentations to community services

•  Improved care coordination/planning due to increased availability of specialist advice/input into cases – Eating disorders, 16-25 and transitions

•  People with Severe Mental Illness will have better access to the Annual Health Checks and post check monitoring of their physical health – new model looking to achieve 60% by end 22/23

Increased readmission rates in B&NES with high acuity and complexity across inpatients

•  Increased community crisis support available with investment into the Wellbeing House model across BSW

•  Improved inpatient experience – e.g. works undertaken at Cedar Ward (B&NES Dementia Care Ward) and Elizabeth Casson House (female PICU)

Increased demand across crisis/urgent care services

•  Crisis lines and wellbeing cafes offering a community alternative to clinical response to crisis

•  Co-location of health and third sector teams in Acute Hospitals to enable non-clinical contact/follow up support

•  Committed to improving services locally – enable availability through telephone, face to face and digital platforms

Staff wellbeing and development

•  AWP provider of BSW Wellbeing Matters Hub to provide response to all staff affected by Covid

•  B&NES locality Senior Management Team offer monthly Ask Us Anything session to all staff

•  Community Mental Health Framework investment in new leadership and apprenticeship roles and training opportunities in B&NES

Demonstrating meaningful impact of services/investment

•  Introduction of clinical outcome measures will demonstrate level of change for the person – measurable along care pathway

•  Uptake of population health management data will enable targeting of investment/services to known health inequalities

Kate Morton, Bath Mind said that it was heart-warming to see us all now working together and being able to influence how services are provided.

She stated that co-location working has been great for all services involved and that huge in roads are being made in many areas. She added that they are enabling many people to access community services.

The Chair said that it was good to see that the partnership was strong and that she would welcome updates on this issue in the future.

Kate Morton replied that they were in year 2 of 3 for the project and that they were reshaping through their continuing engagement.

Councillor Liz Hardman asked if further comment could be given with regard to the increase in the number of people suffering from eating disorders and the timeliness in terms of when individuals can be seen by a specialist.

Jane Rowland replied that provision for this area of work was supplied by Oxford Health and AWP and that there had been a 13% increase in cases in the past year.

She added that conditions such as anorexia, bulimia and disordered eating would all form part of this work and all require a different type of response.

She said that further funding had recently been received and although they were currently below their target figure for routine referrals within 4 weeks they were hitting their target figure for urgent referrals within 1 week.

She explained that there is an Eating Disorder Steering Group in place and that they are considering how to implement guidelines for these conditions within our services.

She said that where possible they will work with individuals to help manage their condition.

Kate Morton added that early intervention in these matters was critical and said that there is a programme in place to help young people.

Councillor Paul May asked for an example of specialist centres that were situated within B&NES.

Nicola Hazle replied that In-patient mental health services were provided at Hillview Lodge, RUH comprising of the 15 bed Sycamore Ward and the 12 bed Cedar Ward for dementia care. She said that this would have been previously known as Ward 4 at St Martin’s Hospital.

She added that B&NES residents could also access services at other sites across BSW, including those for psychiatric services, eating disorders and mother and baby services.

She said that they will work with individuals and families where possible to facilitate admissions and aim to keep them as local as possible. She added that they would use private providers if necessary.

Councillor May asked what controls were in place over private providers.

Nicola Hazle replied that they are regulated by the Care Quality Commission (CQC) and that AWP has a dedicated bed management team to build relationships with local providers.

Councillor May said that he valued the arrangements that were in place to work with 3^rd sector groups such as Bath Mind, 3SG, Mentoring Plus and Off The Record.

Kate Morton replied that Bath Mind was one of four providers of mental health services across BSW that includes Swindon & Gloucestershire Mind, Alabare Christian Care & Support and Rethink Mental Illness. She said that a strong collaboration exists and that the aim is to have a network of networks in place.

Councillor May asked what provision was in place for schools locally.

Jane Rowland replied that there were six waves of support in place across BSW, with two within B&NES to support pupils / schools. She added that it was vital to have early access to services.

Councillor May commented on thoroughness of information in the presentation, but asked if some comparable data for B&NES and BSW case numbers could be shared with the Panel.

Jane Rowland replied that they do have data available and would circulate it to the Panel via the Democratic Services Officer.

The Director of Adult Social Care thanked them all for the presentation and said that one element she would like to see in a future report would be a case study / individuals experience and the views of a local expert.

Jane Rowland said that they had welcomed the opportunity to discuss this matter with the Panel. She added that an integration of services was important and that the Local Authority is part of that as well as the NHS.

Councillor May thanked them for all the services that they provide and asked for all staff to be thanked as well.