Issue - items at meetings - Mental Health Commissioning and Estates Strategy: NHS Brighton & Hove

Further information on plans to develop mental health commissioning in the city (discussion).

33.1    Richard Ford, Commercial Director of the Sussex Partnership NHS Foundation Trust (SPFT), and Jane Simmons, Head of Partnerships and Public Engagement at NHS Brighton & Hove (NHSBH), answered members’ questions on plans to reconfigure mental health services for city residents.

33.2    Mr Ford told members that a major re-design of the mental health services provided across Sussex by SPFT was underway. This initiative is called “Better By Design”, and involves SPFT working closely with the four Sussex Primary Care Trusts, including NHSBH. Better By Design is driven by the need to innovate in order to improve services and also by the need to achieve value for money, particularly given the current economic outlook.

33.3    Better By Design will look at every aspect of mental health services provided by SPFT:

• In terms of community services, the aim is to ensure that these services are effectively aligned with primary healthcare (e.g. GP surgeries); that the totality of mental health services are centred upon community care, rather than community services being ‘bolted on’ to a pre-existing mental health system (as is currently often the case); and that community services are able to deliver a Sussex-wide target of four weeks from presentation to assessment/treatment by Community Mental Health Teams (CMHTs).

• In terms of day hospitals, the aim is to ensure that these services are responsive to user needs. (Currently, these facilities tend to be available Monday to Friday 9-5, whereas demand tends to be highest out of hours and at weekends.)

• In terms of specialist services, the aim is to develop Sussex capacity to deal with conditions such as eating disorders, substance misuse and personality disorders; to significantly increase the number of county in-patient beds for people with Learning Disabilities; and to significantly increase the capacity of county secure and forensic services. It will not be possible to duplicate these specialist services at locations across Sussex, so patients may have to travel to access these facilities (although many journeys will be shorter than they currently are, as significant numbers of Sussex residents currently receive specialist treatment outside the county).

• In terms of residential services (e.g. for people with young onset dementia or Korsakoff’s syndrome), the aim is to encourage individualisation of care, giving clients and their families and carers more say in their own treatment.

• In terms of general in-patient services, the aim is to reduce county acute beds by 100 or so, as Sussex is, relatively speaking, over-supplied with mental health acute beds, and could do more to encourage treatment in the community. Both working age and older people’s beds are expected to be reduced.

33.4    Members learnt that, as yet, there were no detailed plans to implement this initiative, as much of the work thus far had involved working out how to weigh matters such as cost, access and quality of service when making reconfiguration decisions, rather than on discussion of what the actual reconfiguration might look like on the ground.

33.5    Ms Simmons told members that there had already been considerable discussion with service users, carers etc. in relation to the Working Age Mental Health Strategy, and that the developed reconfiguration plans would go out to public consultation in due course.

33.5    Both Mr Ford and Ms Simmons offered to meet with members on either a formal or an informal basis to discuss their plans to develop city mental health services.

33.6    Mr Ford and Ms Simmons were thanked for their contribution.