Agenda item

MENTAL HEALTH THEMED UPDATE

The following representatives will report at the meeting.  Presentation attached:

 

·         Parity of Esteem          Dr Jeff Schryer, Clinical Lead MH

·         Dementia                   Shirley Allen, Programme Manager

·         Children and Young      Dr Cathy Fines, Clinical Lead

People

·           Suicide                       Jon Hobday, Public Health Consultant

 

Karen Richardson, Deputy Director of Commissioning and Cath Tickle, Senior Commissioning Manager Bury CCG will also be in attendance.

Minutes:

·         Parity of Esteem

 

Dr Jeff Schryer, Clinical Lead for Mental Health, Bury CCG attended the meeting to update Members on the work undertaken on behalf of the CCG with regards to parity of esteem.  The presentation contained the following information:

 

There is a national requirement that Bury CCG increases expenditure in Mental Health by at least the same percentage as the CCG overall growth. Bury CCG growth 2017/18 is 2.01%; 2018/19 is 1.99%.

 

Dr Schryer reported that the CCG would want to ensure Mental Health services are not disadvantaged as a result of other competing pressures, mental health expenditure in the CCG in 2016/17 was cica £31.5m.

 

Dr Schryer reported that work is already underway and that includes planned investments in Children and Young People’s Services (refreshing plan with stakeholders including Local Authority); investments in Learning Disabilities and Dementia, working with local providers to ensure patient safety and working with third sector to improve local services.

 

Recent investments include, safer staffing on wards, early Intervention in Psychosis, Rapid Access Interface and Discharge Service (RAID) and telephone street triage; health minds; big white wall project.

 

Dr Schryer reported that there is an acute transformation pilot to support the crisis pathway and avoid hospital attendances and admissions. This will include:

      Next day clinics staffed by RAID practitioners

      Supported discharge team

      Increase in capacity in the Home Treatment Team

      7 day Community Therapy Programme

      Clozapine Initiation Clinic in the community

 

Dr Schryer reported that there has been a number of recent investments via the voluntary sector including grants to Turning Point, Groundwork and Earlybreak.

 

Questions were invited from those present at the meeting and the following points were raised:

 

In response to a Member’s question, the Clinical Lead for Mental Health reported that the majority of patients would complete a talking therapies session within eighteen weeks.  Once completed the practitioner would look at the patient’s need and how they have responded to the treatment before deciding what course of action to take next.

 

With regards to only 15% of patients with depression accessing psychological therapy support, Dr Schryer reported that this is a relatively new service and it is hoped this will increase to 25% by 2020/21.

 

Dr Schryer reported that mental health service providers are actively engaged in providing training to police officers in how to recognise members of the public who may be in distress as a result of a mental health condition.

 

In response to a Member’s question Dr Schryer reported that funding for projects in the voluntary sector are usually for two years.  The providers must evidence how the work undertaken relieves pressure in other areas of the NHS as well as evidence outcomes.

 

In respect of funding for mental health services, the Commissioning Manager reported that the CCG is working with a number of different agencies to better recognise mental health problems before they escalate to crisis point.  The Director of Public Health reported that one of the workstream within the Locality Plan is the Children and Young People’s Plan, the aim of this work is to take a holistic approach to tackling mental health including providing support for the whole family.

 

·         Dementia

 

Shirley Allen, Programme Manager Bury Council attended the meeting to provide members with an update with regards to the work being undertaken to support people in the Borough suffering from Dementia.  The presentation contained the following information:

 

The Programme Manager reported that 1773 people have received a diagnosis of dementia and the forecast prevalence of people who may have dementia in Bury is 2041.  Of 397 people referred for a dementia diagnosis in 2015 – 70% received a diagnosis and of these only 12 waited for longer than 6 weeks for their diagnosis.

 

The Programme Manager reported of those people with a diagnosis – 362 are receiving home care, 383 are receiving care in a residential setting and 1032 are receiving neither.  Hospital admissions for people with dementia are 42.5% per 1000 and 16.2% were re admitted to hospital these figures are the best in Greater Manchester.  The Length of stay is 11.1 days per admission, the Programme Manager acknowledged that there is some improvement required in this area.

 

The Programme Manager reported that the key is to provide Aaperson centred approach and this is should be at the heart of good dementia care.

 

Dr Schryer reported that the role in primary care is to assess, diagnose and manage ‘non-complex’ cognitive impairment/dementia in primary care without referral to the specialist Memory Assessment Service (MAS).  Primary care clinicians are now expected to manage their patients along the whole pathway in the same way as other long-term conditions.

 

Dr Schryer reported that each practice has appointed a named Dementia Clinical Lead (DCL) a comprehensive ongoing education programme for DCLs – led by consultants and other specialists including Dementia Adviser Service has been established.

 

The Dementia Advisor Service is an integral part of the redesigned pathway, the service provides information covering diagnosis, signposting to available support, coping strategies and planning for the future for people with dementia and their carers.

 

Dr Schryer reported there is a great deal of work underway to up skill GPs to better understand Dementia.  GPs, Opticians and Pharmacists will be aligned to Care Homes to improve consistency in care and also to try and keep patients out of hospital, where appropriate.

 

In response to a Member’s question the Programme Manager reported that replacement care can be offered for someone suffering with Dementia, if it is identified within the person’s personal support plan.

 

·         Children and Young People’s Plan

 

Cath Tickle, Senior Commissioning Manager Bury CCG attached the meeting to provide Members with an overview of the Children and Young People’s Plan.  The plan was published in November 2015 and details the local strategy to meet these objectives and improve health and wellbeing outcomes for our children and young people. Since publication the CCG has:

  1. Commissioned a new community eating disorder service, which will soon operate from Bury town centre.
  2. Developed and recruited to a new ‘link worker’ role within the Healthy Young Minds Team. The two link workers provide mental health advice, guidance and support for schools and other services – better enabling prevention and early help.
  3. Implemented the Single Point of Access.
  4. Begun co-working within the new Neighbourhood Hubs.
  5. Commissioned specific support from local 3rd Sector organisations including Early Break and Homestart.
  6. Significantly reduced waiting times for Healthy Young Minds (CAMHS). 
  7. Continued to work closely with GM colleagues to develop crisis resolution and liaison services.

 

The Senior Commissioning Manager reported that the current plan will be refreshed and republished by the end of March 2017.

 

With regards to concerns raised, the Senior Commissioning Manager reported that the workforce needs to adapt and work in partnership and be more alert to identifying those in need of mental health support.  The CCG work with vulnerable groups including Looked after children and young carers to understand their needs and any support they may require.

 

 

·         Suicide update

 

 

Jon Hobday, Public Health Consultant attended the meeting to provide members of the Committee with an update in respect of the scale and cost of the problem, to raise awareness of the key factors; what is happening to address this and what more can be done.

 

6 key areas for actions 

         Reducing risk of suicide in high risk groups

         Tailoring approaches to improve mental health in specific groups

         Reducing access to means of suicide

         Providing better information and to support those bereaved or affected by suicide

         Supporting media to delivering sensitive approaches to suicide and suicidal behaviour

         Supporting research, data collection and monitoring

         Reducing rates of self harm as a key indicator for suicide

 

The Public Health Consultant reported that a recent Greater Manchester Suicide Audit identified key themes and factors which included; Social isolation; physical health conditions; relationship problems and breakdowns; job loss, job issues, and long term unemployment; financial problems including benefits and debt.  Drugs and alcohol was a common theme with some very high intake of alcohol.

 

The Public Health Consultant reported that suicide rates in Bury have been reviewed, audits have been undertaken as to what activities each agency is doing to reduce/prevent suicide.  A suicide multi agency action plan has been developed.

 

It was agreed:

 

A sub group of the Health Overview and Scrutiny Committee will be established to review the Bury Suicide Prevention Action Plan.

 

Supporting documents: