Agenda item

This report provides an update from the Kent and Medway NHS and Social Care Partnership Trust (KMPT)

Discussion:

The Chief Operating Officer of KMPT introduced the report which provided an update from the Trust.

The following issues were discussed:

·       Increase in mental health problems due to Covid – how the Trust was coping with the increase in mental health problems in the population due to the pandemic was questioned. The Chief Operating Officer considered that patients during lockdown tended to know how to access mental health services and, similar to other health services, the Trust had seen a reduction in referrals.

Post lockdown it was clear that large groups of people who had not previously used the service were seeking help. This included people with autism, those who had lost their jobs, people who had not fully recovered from Covid and those who had been well for a long time but had a psychotic condition which had worsened due to the lockdown. There had not been a significant increase due to domestic violence.

·      Britton Farm – Members welcomed the opening of the new community mental health hub at Britton Farm and asked how the services available there were being communicated to the public. The Chief Operating Officer replied that the website had been refreshed to make it clearer what services were provided and other non-digital opportunities to engage with the public were being looked at. The possibility of an article in Medway Matters to highlight the available services was suggested by Members and accepted by KMPT.

·      Mental Health, Learning Disability and Autism Improvement Board – in response to a query, the Chief Operating Officer undertook to provide details of who from the Council was represented on the Board.

·      Individual Placement with Support (IPS) – the importance of increasing access to IPS to enable people with severe mental illness to find and retain employment was emphasised. The Chief Operating Officer commented that funding had now been provided so the Trust could provide this service in Medway and there were opportunities to bid for more funding to expand the service.

·      Section 136 health placed-based places of safety – whether there were sufficient places to cope with the increased demand from Covid was questioned. The Chief Operating Officer advised that the Trust were working with the police to ensure that the power to remove someone from a public place to a place of safety was only used where necessary. The Trust had not had to place anyone in an out of area placement due to Covid, unlike most other Mental Health Trusts. The Support and Signposting service was in place for people who needed crisis support for up to 24 hours where the person could get support and have time to  de-escalate. There were also safe havens for people who did not meet the S136 threshold. The Trust was working with partners to use resources as effectively as possible. There had been a decrease in the use of S136 powers in Medway. Many people did not require admission but rather additional, alternative support such as that described above. Kent Police were being supported so they had access to clinical support from the Trust in deciding the right course of action.

Providing additional beds was not the issue and S136 options could generally be provided when needed but there could be tensions caused by delays in responding to someone who needed attention where the patient was elsewhere in the system, such as A&E.

·      Talking Therapies – in response to concerns about the increase in referrals to this service, the Chief Operating Officer explained this was not a service provided by the Trust, but the comments made would be relayed to the CCG.

·      Joint working with Department of Work and Pensions (DWP) – the possibility of the Trust forging links with the DWP’s Universal Credit team so that the latter could seek advice if they were concerned about the mental health of someone receiving or applying for Universal Credit was suggested.

·      Crisis Resolution Service – the point was made that many people had experienced problems accessing this service. The Chief Operating Officer agreed this was a work in progress and the service needed to be reviewed. Moving to a 24/7 crisis assessment response was key to improving the service as well as improving the home treatment offer as an alternative to hospital admission.

·      Physical Health checks for people with a Serious Mental Illness (SMI) – noting the requirement for people on GP SMI registers to have their physical health checked annually had not been met, it was queried whether the Public Health team could help with this. The Chief Operating Officer commented the Trust was looking at how they could work better with GPs and make their clinical offer more available. The Director of Public Health assured Members his team had been encouraging the take up of annual health checks and was focused on achieving the 75% target.

·      Voluntary and Community Sector (VCS) – the point was made that many VCS organisations who supported mental health patients were struggling and should not be overly relied on, although those who did have capacity should continue to receive mental health referrals. The Chief Operating Officer advised that the community mental health framework programme offered a chance to create a very different relationship with the sector in terms of how people with a mental health issue were looked after and there was an opportunity to ensure finance was channelled to the sector to support this.

·      Signposting and support for families with Mental health issues – concerns were expressed about people with mental health problem finding it difficult to get help. The Chief Operating Officer acknowledged the mental health system was fragmented and could be difficult to navigate. Efforts were being made to understand how the system could be made to work better.

Concerns were raised about people finding it difficult to get support, particularly where a member of a family needed help and the potential major impact their condition could have on the family. How the Trust dealt with confidentiality issues in this situation was queried. The Chief Operating Officer commented that the issue of patient confidentiality presented many difficult challenges. The views of a person living with someone with mental health problems should always be taken into account and listened to, accepting there could be sensitivities about what information could be shared. The Director of People - Children and Adults commented that mental health professionals when working with an adult would always consider who else was living in the household. Similarly, social workers working with children should consider issues of domestic violence and poor parental mental health and potential substance abuse, particularly as it seemed likely the latter was now more prevalent due to Covid.

·      Statistics – a request was made for future reports to have more statistical information, including number of referrals, where they originated from and how they compared to previous years as well as splitting the Kent and Medway target so the Medway figures were available.

Decision:

The Committee agreed to:

a)      note the update provided by KMPT.

b)      request that a Member site visit to the new community mental health centre at Britton Farm be arranged, at a safe and appropriate time.

c)      request that an article on the new community mental health centre at Britton Farm be included in Medway Matters to highlight to the public the services provided.

d)      request that the Trust discuss with the Department of Work and Pensions how to work together so that the DWP’s Universal Credit team were able to  seek advice where they have concerns about the mental health of their customers.