Agenda item - Presentation on Mental Health Services and Covid

Presentation from Brighton & Hove CCG and Sussex Partnership NHS Foundation Trust on planning to deal with Mental Health pressures with regard to the Covid emergency (verbal)

31.1    This item was introduced by Anne Foster, Head of Mental Health Commissioning, Sussex CCGs; and by Dr Rik Fraser, Chief Medical Officer, Sussex Partnership NHS Foundation Trust (SPFT).

31.2    Dr Fraser told members that:

·         There has been a real and sustained surge in mental health demand during the pandemic.

·         This has included anxiety/depression, some in terms of new referrals, some in terms of pre-existing conditions that have been aggravated.

·         Some patients and some medical staff (e.g. ICU staff) have presented with Post Traumatic Stress Disorder.

·         There has been a surge in demand from children and young people.

·         Health inequalities have been exposed by the pandemic and by the associated economic fall-out.

·         Acute demand did fall at the start of the pandemic, but wards are now full. There is also increased demand in primary care.

·         There was a fall in young people presenting for care at the start of the pandemic, but demand is now in excess of normal levels, particularly in terms of eating disorders and ADHD/autism. Services are also seeing increasing acuity in people presenting for care.

·         Demand for beds means that a number of city patients are being treated out of area, but within Sussex. There are also instances of patients having to be treated outside Sussex.

·         Eating disorder demand is currently around three times commissioned activity. Many people are presenting at an advanced stage of illness.

31.3    Anne Foster outlined local responses to this challenge:

·         A local mental health cell has been established.

·         The mental health helpline has been enhanced.

·         New crisis prevention services have been introduced.

·         Support is being offered virtually and via blended virtual and face-to-face offers.

·         A staff support service for all NHS staff has been introduced.

·         An additional £8 million has been invested across Sussex (£1.8 million in Brighton & Hove). This funding has been focused on crisis services; discharge to assess; employment support; an online wellbeing platform for young people.

Plans are being developed to:

·         Enhance eating disorder services

·         Capture and retain positive experiences of virtual services

·         Maximise the role of Community & Voluntary Sector, particularly in terms of areas where there are clinical workforce shortages

·         Better support staff.

31.4          In response to a question from Cllr McNair on virtual services, Dr Fraser told the committee that this has been a learning process for services, but that services are gaining a better understanding of what does and does not work well in a virtual environment.

31.5          In answer to a query from Cllr McNair on the mental health helpline, Dr Fraser confirmed that out of hours capacity has been increased, in part in response to customer feedback about long waits.

31.6          In response to a question from Cllr Brennan about additional resources for mental health, Ms Foster told members that there is additional funding in the system: around £2.5 million for Brighton & Hove. This will be focused on crisis services and on services for neuro-diverse young people. Dr Fraser added that there is funding available, but that finding staff is a significant problem.

31.7          Cllr Deane asked a question about the long-term impact of the pandemic in mental health services. Dr Fraser responded that his hope was that the impact would mainly be in the short rather than the long term. However, he remains particularly concerned about the long-term impact on young people.

31.8          In response to a question from Cllr Wilkinson on referrals to CAMHS, Ms Foster noted that it is important to think in terms of the totality of young person services: CAMHS is just the top tier of a much larger system. Ms Foster offered to return to HOSC at a later date to discuss plans to improve young person services.

31.9          The Chair thanked Dr Fraser and Ms Foster for their contributions.