Agenda item

(To receive a report from Justin Hackney, Assistant Director Specialist Services, which updates the Committee on the on-going work to develop and implement a Universal Offer and Mental Health Community Based Model in Lincolnshire)

The Committee received a report from the Assistant Director Specialist Services, which provided an update on the ongoing work to develop and implement a Universal Offer and Mental Health Community Based Model in Lincolnshire. The Committee also received a presentation from Claire Darbyshire, Deputy Director of Strategy, Lincolnshire Partnership NHSFoundation Trust, Rachel Redgrave, Head of Mental Health Commissioning NHS Lincolnshire CCG, Lorraine Graves, the Interim Head of Mental Health Services and the Roz Cordy the Interim Assistant Director of Specialist Services on the Mental Health Universal Offer and Community Based Model. 

It was noted that the NHS Long Term Plan, published January 2019, had made a commitment to transforming mental health services so that people with severe mental illness were able to access better care, closer to home. Lincolnshire’s approach to supporting people with serious mental illness had been bolstered over the previous two years, thanks to it being one of twelve areas across the country to benefit from significant additional national funding via the NHS. As a health and social care 'system' Lincolnshire was an ‘early implementer’ site for testing new models of care for young, working age and older adults who had moderate to severe, long term mental health problems. As well as radically redesigning how community mental health services operated and integrated dedicated mental health workers within local primary care and neighbourhood teams, the money had also helped to develop new dedicated support for people with a personality disorder, as well as those transitioning from mental health rehabilitation services back into the community.

The Universal Offer started with Community Crisis Care transformation funds of £543K in 2019/20 and £680K 2020/21 to fund three initiatives: A 24/7 mental health helpline; Increasing the current crisis vehicular response, consisting of a crisis nurse and a driver operating from 2pm to 10pm seven days a week to provide one vehicle 24/7; £245K allocated to support the third sector to develop crisis cafés in neighbourhoods. Reference was made to the launch of a confidential mental health and emotional wellbeing helpline in November 2019 which was a joint initiative across health, social care and the third sector, available 24/7. The Covid-19 pandemic had accelerated the need for this work as mental health issues were one of the impacts of this.

Key features of the new community based mental health services were a new place based mental health workforce that was integrated and co-located with Neighbourhood Teams (NTs) and Primary Care Network’s (PCNs). This was not a separate service or team, but a constituent part of the existing NTs which already included GPs, social care, emergency services, substance misuse workers and third sector providers.

The Universal Offer and the Community Mental Health Model would continue to be developed, and over time, as more NTs and PCN's developed, the two models would become one as they worked together and complemented each other's work which was starting to show in the four accelerator sites of Boston, Gainsborough, Grantham and Lincoln South. It was anticipated that by 2023/24 there would be countywide integrated place based MH teams, Countywide Community Rehab - 3 teams and a Countywide Personality Disorder Service – 2/3 teams.

The Executive Director of Adult Care and Community Wellbeing, reminded the Committee that demand for mental health services was increasing as was the complexity of cases being presented. Resources in the service were mostly locked into funding institutional care which included mental health in patients and residential and nursing care. It was because of this that there was a deficit of community provision and accommodation creating a cycle of dependency which was a major challenge. He reported that a report on the future joint commissioning arrangements would be presented to a meeting of the committee later in the year.

During discussion, the Committee raised the following points:

·               The Committee congratulated and thanked all those involved in developing the Mental Health Universal Offer and Community Based Model. This was seen as a good example of partnership working in Lincolnshire.

·               The Committee welcomed the digital offer for mental health, including cardiac rehabilitation, which had received excellent feedback. It was recognised that during the current pandemic there was still a demand from those who were unable to access services digitally.

·               It was recognised that the programme had been developed to connect organisational resources to work together to support people and in some circumstances would be dependent on the ability and speed of response from job centres. It was noted that the Department for Work and Pensions had increased their number of employment advisors recently. It was confirmed that there was the ability to connect to other health and other relevant agencies across county borders in order to support individuals.

·               Members were pleased to note the funding allocated to perinatal care.

·               The 24/7 mental health helpline was particularly welcomed and members requested copies of the poster to be emailed to them and for the service to be publicised as widely as possible. It was noted that latest information showed that 40% of callers were new callers. A call plan was being developed to assist regular callers obtain the support they required.

·               The simple visual messages posted on Facebook promoting services were supported as an excellent idea.

RESOLVED:  That the report be endorsed and the comments made as outlined above be noted.