Agenda item

The report provides an update on the work of Kent and Medway NHS and Social Care Partnership Trust (KMPT).

Discussion

The report provided details of strategic mental health work taking place across Kent and Medway in relation to the Sustainability and Transformation Plan, as well as local work being undertaken by KMPT services. Mental health had a high profile on the national agenda. Nationally, £2 billion of funding had been announced for mental health. It was not yet known how much of this Medway would receive.

Mental Health was a significant part of the NHS Long Term Plan. Priorities highlighted in the Plan included prevention, child mental health, access to talking therapies, mental health crisis response, pregnant women / new mothers and suicide prevention. In relation to suicide prevention, the rate in Medway had reduced by more than the national average. The Medway Early Intervention team was performing well and consideration was being given as to how it could link with acute partners in relation to crisis response access to mental health. KMPT had recently received the results of a Care Quality Commission (CQC) well led inspection. This has been very positive with ratings having improved in nine inspection areas and the overall rating having been good. The caring domain had been rated as outstanding.

The Ruby Ward at Medway Maritime Hospital, which deals with older female patients, had had its estate judged by the CQC to be not fit for purpose. This would be renovated as part of KMPT’s Estate Plan. The plans to relocate mental health services from Canada House in Gillingham and Elizabeth House in Rainham, to a new facility at Britton Farm, Gillingham were progressing. Public consultation was being planned, with it being anticipated that a Consultation Plan would be ready to share later in spring 2019. A Councillor visit was due to be arranged in the summer to the KMPT hub in Ashford.

Work was being undertaken to consider how to provide mental health intervention at an earlier stage, especially in relation to primary care. KMPT aimed to work with NHS 111 to enable people to use it as a single access point rather than having to contact multiple organisations in order to get information or a referral. A good relationship had been established with the CCG mental health GP lead, who was helping with GP engagement plans. Staffing mental health services remained a national challenge with 30,000 mental health practitioners being required. It was expected that KMPT would be able to meet its financial targets while maintaining high quality services.

Questions asked by Committee Members were responded to as follows:

Support when a crisis recurs – A Committee Member expressed concern that there was a lack of support available for patients when a mental health crisis recurred. Intensive therapy and monitoring would come to an end and it was then challenging for people to regain access to services. Recognition and awareness of mental health difficulties amongst GPs also tended to be low. In response, the Chief Operating Officer of KMPT said that access to mental health care when in crisis was included in the NHS Long Term Plan. She agreed that there was a general lack of understanding about what patients required when in mental health crisis and said that the demand for assessment had outstripped capacity. Engagement with the CCG GP Mental Health lead could help to raise awareness amongst GPs and to consider how approaches could change.

Personality Disorder Pilot – There had been a national focus on people diagnosed with personality disorder with good work having taken place in the last couple of years. The KMPT pilot had provided up to eight 1 to 1 sessions for people with Personality Disorder. This included helping them to identify triggers and coping strategies. The pilot had recently finished. It would be evaluated with a view to rolling the service out across Kent and Medway.

Section 136 Provision and Street Triage – A Member noted that there continued to be no Section 136 suite in Medway. He felt that Street Triage was embedded and working quite well but was concerned what would happen at times when it was not operational. The Chief Operating Officer said that Section 136 provision was available at five sites in Kent and Medway. It would be challenging to provide provision at additional sites with there being no plans to provide a site in Medway. Street Triage currently operated on four evenings each week but discussions were ongoing with police and commissioners about extending the service.

Dual Diagnosis – The report had not mentioned this, particularly in relation to substance misuse and support in relation to mental health issues was currently poor. The Committee was advised that KMPT was engaging with Medway Public Health to work on dual diagnosis with the KMPT Deputy Chief Operating Officer leading on this work. There was a need to bring existing services together to better serve patients.

Decision

The Committee:

i)     Noted and commented on the report.

ii)    Agreed that a service user of the Mental Health Community Outreach team be invited to address a future meeting of the Committee.