To brief the Health Scrutiny Committee on the new provider for Mental Health (health and adult social care) and Learning Disability (health) and progress with mobilisation of the new contract.

The Committee was informed of the appointment of  the new provider for Mental Health services (health and adult social care) and Learning Disability services (health) and progress with mobilisation of the new contract, due to come into force on 1 April 2011.

Mr Shaun Clee, Chief Executive of 2gether NHS Foundation Trust, the new provider, gave a presentation.

The Trust’s purpose was:  “To make life better.  All of our focus is on improving lives for the people we serve and this will be a key test of strategy decisions.”

The Vision was: “We will offer services that are desirable to individual customers, that our staff want to deliver and at a price commissioners can afford.”

The Core Values were Seeing from a service user perspective, Excelling and improving, Responsive, Valuing and respectful, Inclusive, open and honest, Can do, Efficient, effective, economic and equitable.

He commented on the existing connections between Gloucestershire, where the Trust currently operated, and Herefordshire, including clinical networks.

The Trust’s proposed approach involved a dedicated Herefordshire locality Strategic Service Unit with local leadership and full access to central support services.  He commented on steps taken to date to engage with staff and service user and carer groups, demonstrating the Trust’s aim of being accessible and responsive.  The Service user voice would be heard.

His own approach would be straightforward and honest.  The Trust would not get everything right.  Where it had made a mistake it would own up and seek to correct it.  Where, having investigated a complaint, the Trust considered it had acted correctly it would robustly defend its actions.

There would be an increase in the following, which the Committee could monitor and challenge:

·         Access rates per 100,000

·         % of individuals provided with appropriate alternative to admission via crisis and home treatment services (He noted that the number of people admitted to hospital in Herefordshire was considerably higher than in Gloucestershire. Community Services needed to be bolstered to support people living in their own homes.)

·         Year on year patient satisfaction scores

·         Service User and Carer, Staff and Whole Systems Partners satisfaction

·         Compliance with CPA to 100%

·         % of individuals discharged from inpatient care seen within 5 days face to face (not 7 days)

The Trust also expected to make significant reductions in the following:

·         % of unplanned readmissions within 28 days and 90 days

·         Waiting time for routine provision

·         Year on year sickness levels

·         Length of stay for those requiring admission

·         Reliance on agency leading to improved productivity and quality consistency

·         Reduction in delayed transfers of care

·         % of individuals in contract with services who spend time as an inpatient

·         Year on year harm from serious untoward incidents

·         Beds within the service

·         Expenditure on anxiolytics within Primary Care

·         GP appointments for individuals with mild to moderate symptoms of depression, anxiety and obsessive compulsive states

He viewed the Scrutiny function as a critical friend and would be happy to provide updates to the Committee as required.

In discussion the following principal points were made:

·         In relation to learning disability services Mr Clee reassured the Committee that the Trust had a large learning disability service and would provide the health component of care recognising the importance of joined up working with social care. The Trust was also working with the Commissioners to deliver appropriate packages of care within the County that would allow people who currently had to have their care provided out of County to return to the County.

·         It was noted that the contract was for 3yrs with an opportunity at that point to extend the contract for a further two years.

·         Mr Clee commented on the ability within Gloucestershire (Increasing Access to Psychological Therapies) for people to access services without the requirement of a GP referral.  Discussions were taking place with GPs about care pathways. 

·         Mr Clee acknowledged that provision for children and adolescents with mental health problems was one of the most challenging areas of service.   He was proposing a different model of working and expected there would be some robust discussions over this issue.

·         Mr Clee commented that one of the Trust’s priorities was to reduce the number of in patient beds from 29 to 16 by the end of the first year of the contract.  Benchmarking with other providers indicated that no more than 16 beds should be required. However, this did depend on safe services being available in the community and risk being managed appropriately.   He assured the Committee that the service would be operating 24 hours a day seven days a week so there should be no gap in service provision.

·         He reassured the Committee that the proposed reduction in beds was not to meet a national target but had been negotiated locally with Commissioners.  He considered this was the right approach for the Community.  The Trust had implemented this approach successfully in Gloucestershire and was aware of potential risks.

·         Asked about the implications for the Stonebow Unit, Mr Clee said that as he had

indicated earlier the agreement with commissioners was to reduce the number of

adult acute beds from 29 to 16 by the end of the first year. The number of beds

for older adults currently appeared about right and there were no current plans to

change the number of older adults beds at the Unit.

In conclusion Mr Clee assured the Committee of his commitment to work with partners to raise awareness of mental health issues and seek to ensure that the attitude to people with mental health problems changed.

RESOLVED:  That it be recommended that a progress report be made in 9 months time as part of the scrutiny work programme.