Agenda item

Members are asked to consider a paper which provides an update on;

 • the impact of COVID-19 on the demand for mental health services.

 • the transformation of the wider mental health services, in particular  the transformation of community mental health services and urgent and emergency care mental health services.

• the transformation of dementia services, including the redesign of dementia services for people with complex needs.

Discussion:

Members considered a paper which provided an update on the following areas:

•       The impact of COVID-19 on the demand for mental health services.

•       The transformation of the wider mental health services, in particular the transformation of community mental health services and urgent and emergency care mental health services.

•       The transformation of dementia services, including the redesign of dementia services for people with complex needs.

Members discussed the following issues:

·       KMPT crisis line – a reference was made to long waiting times for self-referrals and a recorded message people received when they telephoned the crisis line which advised them of alternative services before cutting off. The point was made that this would often be frustrating for people with mental health issues. KMPT responded that this recorded message asked colleagues in other services to email rather than wait for their call to be answered. This was due to a significant increase in demand for this service and allowed staff to concentrate on caring for patients. There were challenges around waiting times, partly due to demand. The plan was to transition to the 111 service to provide a more robust service. A new telephony system was being purchased due to some problems with the existing service. Members were assured that the recorded message on the crisis line did not direct people to go to their GP.

·       Performance – A comment was made that people had to often re-tell their stories when receiving treatment for a crisis and had to use different services. The CCG acknowledged the importance of people not having to re-tell their stories and commented that there were plans to reduce the number of assessments and make services more conducive to the needs of the individual. A point was made that service users often received support without any results and suffered from a “revolving door” situation and that the  transformation programme was a chance to offer people professional help at the right time. KMPT commented that the proposals were designed to enhance community services to bring help closer to where people lived. However, this could never be 100% effective. There was a need to move away from focusing on crisis care and to help people before they were in crisis. The proposals aimed to achieve that.

·       Talking therapies – a briefing note on the effectiveness of this service was requested in the light of negative feedback reported to a councillor. Demand for these services had dropped due to Covid but the expected increase in demand had only recently happened. An undertaking was given that the next update would include performance information on the voluntary and community services referred to in the report.

·       Move to Britton Farm – how the move to this venue had gone was questioned and a reference was also made to some service users seeking specialist medicine at Britton Farm in a distressed state. How KMPT linked up with other services in this situation was queried. KMPT commented the move to Britton Farm had gone well and assured Members that patients were assessed holistically. If there were any safeguarding concerns then the appropriate referrals would be made to partners and complex cases would be discussed with multiple agencies.

·       Support for carers of people with mental health needs and dementia – KMPT undertook to provide an update on this in the next report to the Committee.

·       Admiral nurses – referring to the review of the provision and model of delivery of Admiral nurses to ensure a consistent offer across Kent and Medway, the additional funding was welcomed but it was questioned whether provision in some areas might be lowered. An assurance was given that this would not be the case and provision would be enhanced.

·       Kent and Medway’s dementia diagnosis rate – whether this rate was the same nationally and whether GPs received support in diagnosing dementia was queried. KMPT advised benchmarking with other regions showed it was unusual for a secondary care provider to carry out all the diagnosis work. The plan was to introduce a hybrid model where secondary and primary care providers undertook this role. There would be an investment in training so GPs could be supported in this.

·       Community crisis alternatives – with reference to the surge in people needing crisis care who were autistic, the lack of new investment for this group was queried. KMPT advised there had been investment in this service but the funding related to 2020/21, which was why it was not listed in the table showing funding for 2021/22.

·       Therapeutic Acute Mental Health Inpatient Care  - how the planned improvements to this service would be measured was queried. KMPT undertook to report back on this.

·       S.136 Suites – the point was made that more of these detention suites were still needed and whether the pilot scheme involving mental health nurses working with the police was continuing was questioned. Regarding the latter, Members were advised that there had been two pilot schemes but an increase in the number of people in S.136 suites meant they had not achieved their outcome and they had been discontinued. However, another Trust had achieved some success with this approach and the matter was still under review. A request was made for the Committee to be updated on any progress.

·       Investment into the dementia pathway to improve memory assessment services -  whether Medway’s share of this national funding, equating to £592k, was in addition to the £51m allocated to transform mental health services in Kent and Medway would be clarified.

·       Local services – how “locally” was defined as mentioned in the update was queried. KMPT advised that there was not one definition, and this would depend on the particular service.

Decision:

The Committee:

a)    agreed to note the progress update in the report

b)    agreed that regular updates on Kent and Medway’s mental health and dementia improvement programme continue to be brought to the Committee, including details of numbers and outcomes for the programme.