Agenda item - Neighbourhood Mental Health Teams

Neighbourhood Mental Health Services

34.1    John Child, Sussex Partnership NHS Foundation Trust (SPFT) Chief Operating Officer, presented the paper on changes to SPFT neighbourhood health services. Matt Gough, Chief Executive, Southdown, was also present. Mr Child outlined NHS Long Term Plan ambitions for mental health, including increasing focus on prevention and on community treatment. Implementing this vision locally will require better multi-agency working at a neighbourhood level, building more effective partnerships, and partners working in less siloed ways. Outcomes will include reducing the level of rejected referrals from community to acute services; increasing the percentage of people getting the right referral; better integration between mental health and public health services; and improving efficiency. Community mental health services will be aligned with the 15 Sussex Integrated Community Teams (ICT). In Brighton & Hove this has involved moving from 2 to 3 mental health community teams reflecting the 3 city ICT footprints.

34.2    Angela Savage asked about support for those people, such as older residents, who may struggle with digital services. Mr Child replied that SPFT offers a range of ways to engage with services for those who struggle with digital access. For example, many services for older people are face to face, particularly cognitive assessment services.

34.3    Cllr Parrott raised concerns about the provision of talking therapies online, noting that online provision may be sub-optimal. Mr Child acknowledged that there are issues with providing these types of therapies digitally.

34.4    Cllr Simon asked for details of how local neighbourhood services would be. Mr Child replied that there is not necessarily a single model, but referenced the existing health hubs in east Brighton and in Hangleton & Knoll and examples of what a neighbourhood might look like.

34.5    Cllr Simon asked how outcomes would be measured. Mr Child replied that key outcome measures will include patient experience, prevention outcomes and the number of people presenting at A&E with a mental health crisis.

34.6    Cllr Simon asked about accessing neighbourhood mental health services. Mr Child replied that the aim is to stop people having to go back to their GP to be referred to a different mental health service. Services will be able to refer patients directly to another service and/or there will eventually be a self-referral option.

34.7    Cllr Winder asked about outreach to seldom-heard communities. Mr Gough replied that this is a core part of a new VCSE model that engages more with VCSE partners with good links to harder to reach communities. Mr Child added that there is also lots of work involving people with lived experience.

34.8    Cllr Parrott asked about managing the risk of having gaps in provision when outsourcing to VCS organisations. Mr Child replied that contracts with the VCS are monitored and assured like any other contract. It should also be recognised that there are benefits in contracting with the VCS, particularly in terms of gaining a nuanced understanding of local populations needs which VCS partners are often best placed to deliver.

34.9    Cllr Lademacher asked about engaging with clients for whom English is not a first language. Mr Child responded that translation services are used, as are community organisations where they may be able to assist and support.

34.10  Cllr Hogan asked how the new model differs from the one it replaces. Mr Child replied that the new model is a much more integrated service rather than a group of standalone services. The ambition is also to develop a self-referral pathway which is not currently available.

34.11  Angela Savage asked about Equality Impact Assessments (EIAs). Mr Child replied that EIAs have been completed at multiple points. He would be happy to share these with the committee if requested.

34.12  Cllr Parrott asked about working with people with lived experience. Mr Child replied that there are 2 groups of people here: professionals working in services who have personal experience of mental health issues, and service users who are ‘experts by experience’. Both groups provide valuable insights.

34.13  The Chair asked whether services are fully staffed and are sufficient to meet needs. Mr Child responded that relatively few services can maintain full staffing at all times, and there is inevitably a gap between demand and capacity. However, the services are now live and will have a positive impact.

34.14  The Chair asked about services for people who do not meet the eligibility criteria. Mr Child replied that a range of support is available from the VCS, primary care and neighbourhood hubs. Being able to refer people seamlessly between services is key to the success of the new model.

34.15  The Chair thanked Mr Child for his presentation.

Southdown Wellbeing Services

34.16  Matt Gough outlined the new service model for wellbeing services. Change is required to ensure that services deliver with the NHS Long Term Plan vision, are aligned with the reconfiguration of neighbourhood mental health services, reflect funding changes, meet additional demand, and ensure equity of provision across neighbourhoods in Brighton & Hove and East Sussex. Mr Gough acknowledged that there will be an impact on existing clients. The vision for the new service is to provide a service that is easy to access, welcoming and inclusive, and sustainable. There will be a range of support, including facilitated peer groups, walk-in welcome sessions and social spaces. As well as services provided out of the Preston Park hub there will be pop-up services in local communities.

34.17  Cllr Hill asked about crisis provision. Mr Gough replied that this is provided by the Staying Well service which operates 7 days a week. Mr Gough to provide more details following the meeting.

34.18  Cllr Hill asked about pop-up support for residents of Large Panel System (LPS) blocks facing the demolition of their homes. Mr Gough replied that he was uncertain how many residents had been engaged. This is a new way of providing services and learning from the first events is still being processed.

34.19  Geoffrey Bowden asked whether the changes were driven by the need to save money. Mr Gough responded that cost saving is not the primary focus: the challenge is to support as many people as possible within a set funding envelope.

34.20  Cllr Parrott commented that it was unclear how the new service model differs from the old one and consequently hard to conduct effective scrutiny with the information provided. Mr Gough replied that he could not explain the differences in detail at the meeting. However, in brief the current model offers a range of services via facilitated group sessions, yoga groups, and one-to-one support. The model is popular and had been successful. However, there is little or no capacity to accept new clients. The reconfiguration will reduce some services for current clients, but this is the only way to meet additional demand within the available financial envelope.

34.21  Cllr Simon asked about the evidence-base underpinning the model of 8-week peer group working. Mr Gough responded that this is designed around the ‘5 ways to wellbeing’ model.

34.22  Cllr Simon asked about community pop-ups. Mr Gough replied that the focus is currently on transitioning to the new model. Following this, a pop-up programme will be developed by the new neighbourhood lead.

34.23  Cllr Simon asked by how much social space will be reduced. Mr Gough replied that the current provision of 19.5 hours per week will be reduced to 10.5 hours. In time there may be some scope to run volunteer-led groups to replace some of this lost capacity.

34.24  Cllr Simon asked about volunteering. Mr Gough responded that there will be a new volunteer coordinator. There are also plans to roll-out a new volunteer programme in Brighton & Hove with various roles following the success of the ‘community connectors’ service that operated in East Sussex.

34.25  Cllr Simon asked about attendance figures. Mr Gough replied that the average client attendance is 0.6 hours per week. However, many clients will attend much more regularly than the average suggests.

34.26  The Chair asked why the new model had been adopted and whether existing clients would lose support. Mr Gough replied that the existing model did not provide enough additional capacity to take on new clients, and it was important to try to meet new as well as current client demands. The new model is a refinement of the current model that provides additional capacity. The model has been developed with reference to sectoral research and national best practice. Current service users will experience a reduced level of support. Individual risk assessments have not been conducted by default, but all current clients have been offered one-to-one sessions to assess their needs.

34.27  The Chair asked whether an EIA had been produced. Mr Gough confirmed that it had and he would share both the EIA and the Quality Impact Assessment with the committee.

34.28  Members discussed whether an additional item at committee was required and agreed that the HOSC needed more assurance that the changes would not have negative impacts and that the new model supports a preventative approach. The committee agreed to ask for an update to come to a future meeting.

34.29  RESOLVED – that the report be noted.