Agenda item

A joint report is submitted by the Director for Adult Social Care and Commissioning and Leicestershire Partnership NHS Trust (LPT) providing an update of key challenges, waiting times and joint efforts to address mental health in Leicester City.

The Director of Strategy & Business at Leicestershire Partnership Trustpresented the item, and it was noted that:

·       The local authority and health partners continue to work together to support residents with mental health and all strategies that have been developed feed through into the city’s mental health partnership board which is a sub-group of the Health & Wellbeing Board.

·       Services provided under Leicestershire ‘Step-Up to Great’ Mental Health have now been replaced by Better Mental Health for All.

·       Community mental health services are provided to people whilst they are living at home and are delivered by the local authority, VCSE organisations and health providers. Promoting good mental health and wellbeing in the community helps residents to maintain employment, housing and contribute to society and be part of their community.

·       There have been increasing referrals for adult psychiatry services – now between 300-350 referrals a month across LLR. This has been a challenge for the way of working but initiatives have been underway to increase the workforce by identifying new ways of recruiting, being flexible with a multi-disciplinary team to ensure residents are seen by a professional with the appropriate skills at the right time and undertaking casework reviews. 

·       Perinatal services to support new mothers is on track to meet the target of seeing 1259 mothers, using birth rate indicators, by 31 March 2024 and sustaining the service following an increase in investment.

·       ADHD services remain a big challenge with increasing referrals and the 18week target to see patients is not being met. This is a challenge for all areas across England and work is underway to partner with others to identify solutions. LPT remains the central hub for prescribing medication for residents with ADHD, but spokes have been created by working with community pharmacies to ensure patients are able to access medication until supply is restored.

·       Memory clinics are not meeting targets for expectation diagnosis per population rate. The service is increasing the referrals received - around 316 a month – and currently achieving 65.4% diagnosis with a target of 66.7%.

·       Targets of 95% compliance of seeing patients for dynamic psychotherapy services, psychological therapies and therapeutic services for personality disorders are not currently being met but work is underway for improving.

·       Urgent care has been expanded and includes central access point. Around 167 calls a day are received with average call times reducing from 15minutes to 12minutes. National performance indicators currently will be introduced from April 2024 which will enable benchmarking against other authorities.

·       An urgent care hub is available to try and prevent residents having to go to A&E. The unit has around 270 referrals a month.

·       The crisis service has a caseload between 180-210 patients at any given time. The 4hour response for very urgent cases is at around 80% of the 95% target.

·       There has been investment in the mental health liaison service to provide support to all hospitals in the city. A challenge exists around the timeframes of a patient being identified as needing mental health support and referral being made but LPT and UHL colleagues continue to work together.

·       Leicestershire Partnership Trust is the only trust in the East Midlands not to have placed a patient in an inappropriate out of area. There may be occasions where it is appropriate to be out of area.

·       Health partners work closely with social care to ensure patients who are clinically ready for discharge can return to the community as quickly as possibly but there may be a change in circumstances and complex needs that may create delays.

·       The NHS supports individuals with more severe mental health but other preventative work and championing good mental health and wellbeing can be undertaken and promoted by everyone.

In response to questions and comments from Members, it was noted that:

·       The NHS provides a large proportion of medication for ADHD to adults, but experiences can vary as the private sector and GPs can also prescribe which may be different. 

·       The service has maintained zero inappropriate out of area placements in 2023, ensuring patients receive support in Leicestershire.

·       Partnership working between the health service and local authority ensures patients are discharged from hospital quickly when they are clinically ready. Housing or placement requirement can be an issue with increasing individuals with complex needs but numbers waiting for discharge are low. 

·       Information would be shared with the Commission regarding patients with a learning disability or autism in inpatient settings.

·       The adult memory service is available to patients post diagnosis. Individuals are signposted to VCSE organisations providing different support, support workers with lived experience are being recruited to support families when an individual is diagnosed, alongside other work as part of the dementia strategy.

·       Strategies around preventing death by suicide are in place and it was agreed a specific report will be shared with the commission on the issue.

·       Every missed phone call is a missed opportunity to engage with an individual seeking help and ensuring sufficient and flexible capacity to answer calls requires improvement. Some individuals may call repeatedly and prevent other’s ability to speak to an advisor, but strategies are being explored to support such individuals in different ways and identify a more streamlined approach to be more responsive to calls.

The Commission noted the success of LPT regarding out of area placements and agreed to promote better mental health.

AGREED:

·       The Commission noted the report.

·       Additional information requested to be circulated.

·       Death by suicide to be added as an item to the work programme.