Agenda item

24.1     The Strategic Commissioning Manager (Mental Health) introduced the report, providing the following additional information:

·         The Phase 1 services have been rolled into one contract to reduce overheads. The Wellbeing Centres already existed and there was a desire to continue these in an integrated way with new services.

·         The Personality Disorder Service will operate six days a week and will be fully operational by mid-December 2017.

·         The Crisis Cafes will open until 11pm each day and will link to other available services. The first café will open in Hastings and the model will then roll out to Eastbourne, with both aiming to be fully operational by Christmas 2017.

·         East Sussex was an early adopter of supported employment which has been operational locally for 10 years. The local model is seen as best practice and helps around 200 people with long term mental health conditions back into work annually. The service works closely with crisis teams to help people retain employment.

·         The Community Connector service is new but developed from two previous services. It aims to link people into mainstream services with support. The social prescribing aspect has been piloted in relation to welfare debt, housing, social and other support and saw a 60% reduction in people accessing GP appointments. The Community Connector service will target GP practices with high users of service.

·         The ‘hard to engage’ service has traditionally been provided by Seaview – it aims to build trust with service users and supports access to other services.

24.2     Further points were made in response to questions from the committee as follows:

·         Services expect to be supporting people with multiple needs and will link into drug and alcohol services.

·         The Personality Disorder Service target of engaging with 75 clients per year is linked to the available resource but also how services are being used at the moment. There is currently high use of specialist services by the target group, with poor outcomes, and the new service has been set clear outcomes for clients which are also linked to the impact on other services. There will be wider benefits to a larger group of clients through building the personality disorder expertise of the less specialist services.

·         The Crisis Cafes will operate until 11pm, seven days a week. There is expected to be a consequent reduction in instances of crisis and reduced impact on other services like A&E.

·         The expectation for the Employment Support Service of engaging with 500 clients reflects the total number the service works with each year. This results in 200 (40%) going into employment which is in line with the target. This 40% are able to move away from services and rehabilitate in a different way in the community. The other 300 clients still get positive outcomes from their engagement such as opportunities for voluntary work.

·         The newly commissioned services are funded in large part by different use of established budgets. The new services (Personality Disorder Service, Crisis Cafés and social prescribing) are all Clinical Commissioning Group (CCG) funded with strategic intent to save money elsewhere over the next 18 months. Of the total funding of £2.5m, Adult Social Care funding is £138k which represents a good value investment in terms of meeting Care Act responsibilities, reducing impact on social work and reduced care needs down the line. Some impact on other services is expected straight away but other benefits, particularly on use of acute beds, will materialise in later years and are reliant on changes in other areas.

·         There are specific targets for the new services to reduce demand elsewhere in the system, for example a target saving (across a range of services) of c£680k for the Personality Disorder Service.

·         In terms of financial sustainability, the CCGs which provide the bulk of the funding have financial challenges but there are national expectations on the NHS in relation to investment in mental health and achieving ‘parity of esteem’ with physical health services. This gives relative protection to MH services, spending on which is monitored nationally and also through the local Sustainability and Transformation Partnership.

·         A proactive approach to engagement in local communities has been led by Wellbeing Centres over many years, linking to other services like GP surgeries and the troubled families programme. As a result, the numbers engaged have gone up considerably over time. There is a need to build greater awareness of the hubs in local areas and a  suggestion with regard to engaging shopping centres was noted.

·         There will be a need to work more to engage and embed services with street communities. It is important to be clear about the service offer and engage consistently but ultimately people have to make individual decisions to engage. The need to liaise with a proposed Link Worker in Eastbourne was noted.

·         The locations of the mental health Wellbeing Centres were chosen 12 years ago based on demand and need, but there is flexibility in terms of building in mental health support to other mainstream health and wellbeing centres.

24.3     The Committee RESOLVED:

(1)  To welcome the range of newly commissioned services and to note the need to monitor their ongoing sustainability given the financial situation.

(2)  To request an evaluation of how the services are delivering against the original aims in April 2019.