Agenda item

To consider the report of ‘Transforming Community Mental Health’ outlining partnership work of NHS organisations, Leeds City Council, the Voluntary, Community and Social Enterprise (VCSE) sector, and service users/people with lived experience coming together to transform how primary and community mental health services are currently organised and delivered for adults and older people with ongoing and complex mental health needs (commonly referred to as severe mental illness/SMI).

The Board considered a report which provided an update on the work to transform Community Mental Health in Leeds. The report outlined the collaborative approach to the work undertaken by NHS organisations, Leeds City Council, the Voluntary, Community and Social Enterprise (VCSE) sector, and service users/people with lived experience. Partners had come together to consider the transformation of how primary and community mental health services were currently organised and delivered for adults and older people with ongoing and complex mental health needs (commonly referred to as severe mental illness/SMI).

In attendance for this item were;

·  Liz Hindmarsh – Programme Manager, Leeds Community Mental Health

·  Annette Morris – Involvement Lead

·  Debbie Thrush – Clinical Lead for Working Age Adult Community Mental Health Teams

In introducing the report, the Programme Manager, Leeds Community Mental Health highlighted that approximately 8000 adults in Leeds were recorded on the SMI register, but it was thought that SMI was under-reported. Additionally, people with complex mental health/SMI experienced very different physical health outcomes and their life expectancy could be 15-20 years shorter than other people. Initial consultation on transforming services was undertaken with the Early Intervention Partnership which identified the Partnership would value focus on access to care and compassionate care.

The vision was to:

-  Create a joined-up service from the primary and community mental care providers.

-  To remove any barriers to access to services.

-  The ability for people to access services as early as possible.

-  For people to remain in their community.

The Board received a video presentation which included the ambition to create Integrated Community Mental Health Hubs, to be placed withing Local Care Partnerships (LCP’s). Service referrals will be made to the Hubs where personalised treatment will be delivered by Third Sector partners. A pilot of the Hubs will be trialled in three Leeds LCP’s with the intention to roll out the Hubs city-wide during 2024-25.

The delivery model had been informed through extensive consultation and workshops and would entail a culture change in service delivery, with time for reflection to ensure the roles and relationships were right. The new roles will include:

·  8 Community Wellbeing connector roles - to connect individuals to the right support in their community. The Connectors would be part of the Hub Multidisciplinary Team/VCSE partnership of providers.

·  Peer Support Worker roles – to focus on the emotional/relational element of support for an individual at their time of need. They would also focus on working towards cultural change in services and be part of the Hub Multidisciplinary Team/VCSE partnership of providers.

The Board also received details on the work undertaken and planned which included following:

·  Work was moving from the consultation/engagement phase to involvement and co-production of the service with Healthwatch, to put in place the systems needed to achieve the transformation.

·  Work was ongoing with diverse communities to eradicate the imbalances in the systems and to reduce health inequalities.

·  Work built on the representations made by people with lived experience.

·  Work was being done to support people with mental health issues and service users to communicate the transformation process and new Hub model.

The challenges ahead included:

·  Workforce pressures and the limited supply of roles in the service and current vacancies.

·  The resources required for a project of this size and complexity.

·  Maintaining the energy and pace needed for the transformation and the context of the pressures.

·  ICT systems and inter-operability which can present limits to agility and integration.

Before moving to discussions, Sara Munro highlighted that the transformation process would have an impact over a period of 18 months but was necessary to achieve the change for service users.

The Board discussed the following matters:

·  Evaluation of the pilot Hub model – the pilot Hubs would be rolled out in different areas of Leeds so learning will be taken from each community. Evaluation will be for the whole of West Yorkshire and will include consideration of service users and support for practitioners for them to make their own decisions. Recognising the level of need for services, the Board noted a request for a report back in 12 months.

·  Resources – existing and new staff will deliver the new service model.

·  Priority issue – before Covid-19, mental health was the issue most people raised with Healthwatch. The service transformation required the same priority amongst partners as Covid, especially due to the anticipated service disruption whilst transformation occurs.

·  Inter-operability – focus needed across all providers to ensure the new system works.

·  Estate – a mapping exercise had been undertaken to identify sites, but the issue of mental health services provision in GP practices was being discussed with practices and LCPs.

RESOLVED –

a)  To note the scope, ambitions, approach and progress of the work to date.

b)  To support and endorse the work in Board members’ respective roles, communities and organisations, be noted.

c)  To support with unblocking of barriers around IT and systems integrations and estate by supporting with work on partnership agreements.

d)  To support an appropriate alignment of resource to support effective delivery of this programme and the long-term embedding of culture change that will be required over many years.

e)  That Members comments and recommendations, including the request for a report in 12 months on the transformation, be noted.