Agenda and minutes

Members are asked to declare any interests they may have in the business on the agenda.

Members are asked to declare any interests they may have in the business on the agenda.  No such declarations were made.

Sarah Prema (Chief Strategy and Planning Officer) and John Singh (Long Term Conditions Adults and Older People Manager) have been invited to the meeting to provide an overview of services commissioned, specifically relating to this topic area.

Members previously indicated that they wished to have details of budgets and budgetary trends, comparative data, the processes involved and the monitoring of performance.  Members will be asking questions on these topics and other areas of interest in order to gather evidence for the review.

Sue Locke, (Chief Operating Officer) and John Singh (Long Term Conditions Adults and Older People Manager) attended the meeting to provide an overview of services commissioned, specifically relating to this topic area.

A copy of the presentation to the Commission is attached for information. 

The following comments were made during the presentation in addition to the comments contained in the presentation:-

a)         The CCG commissioned services at all 5 steps of the Stepped Care Model and NHS England commissioned some specialist services at Step 5 as well.

b)         The programmed spend by Leicester City LPT/CCG on Core Mental Health had dropped in recent years as some funds for specialist commissioning had transferred to the NHS England.

c)         The spend was, however, above the national trend for this expenditure and was on par with Derby CCG but below Nottingham CCG on weighted spend per head of population.

d)         West Leicestershire CCG led on contract monitoring, finance and qualitative performance.  This was monitored by the Finance and Technology and the Performance Committees.  These Committees had representatives of all 3 CCGs in Leicester and Leicestershire had GPs on them.

e)         The 3 CCGs spent approximately £80m on mental health services.

f)          The targets for commissioned services were found in the Outcome Frameworks for NHS, Adult Social Care and Public Health and also in the contracts and KPI’s for local providers.

g)         Mental Health was a priority work stream within the Better Care Together strategy.  The CCG was working with GPs so that services could be more responsive to changes in local communities.

h)        The Liaison and Diversion Services had led the way in a national pilot initiative.

i)          Although there was no specific commissioning of mental health services for young black British men, all commissioned services were available to all parts of the community and could be accessed by young black British men.  More work was required to understand why this group were not accessing the services available.  There was a balance to be struck between commissioning services for specific groups and commissioning universal services that were accessible by all.

Following questions from members the following comments and observations were made:-

a)         The voluntary sector provided services for health, counselling and advocacy through Adult Social Care commissioning and a list of the bodies that provided these services at Steps 1-4 could be supplied after the meeting.

b)         The funds transferred to NHS England filled the apparent gap in funding Core Mental Health Expenditure since the CCG was established in 2013.

c)         The CCG Board receive monthly reports on attempted suicides of patients in hospital and patients ‘out of stay’ and the length of stay of patients.  The CCG had raised some concerns with the LPT prior to the CQC initiating their inspection of the Bradgate Unit.

d)         Equality Impact Assessments (EIA) were undertaken for all new service provision and these would also be undertaken for initiatives under the Better Care Together programme.  EIA’s were not always easily accessible from previous health bodies  ...  view the full minutes text for item 10.

Teresa Smith (Director of Adult Mental Health and Learning Disability Services) and Dr Fabdia Noushad (Community Services Specialist Clinical Director) will provide an overview of services delivered specifically relating to this review.

Members previously indicated that they wished to have details of service provision and gaps in provisionbudgets and budgetary trends, comparative data, the processes involved and the monitoring of performance.  Members will be asking questions on these topics and other areas of interest in order to gather evidence for the review.

Teresa Smith (Director of Adult Mental Health and Learning Disability Services) and Dr Fabdia Noushad (Community Services Specialist Clinical Director) provided an overview of services delivered specifically relating to this review.

The following comments were presented during the overview:-

a)         LPT won the tender to be a national pilot site for Liaison Diversion Services which involved working with the Police, Criminal Justice System and the Courts.

b)         The Bradley Commission had made a visit on 10 July 2014

c)         The Trust was working to identify local stakeholders to plan and improve services in response to the Mental Health Crisis Care Concordat issued in February 2014.

d)         Some key service developments will also improve the quality of care of young black people.  A briefing note on these services can be provided.

e)         National data sets are being complied as part of this work which will then be broken down to local levels and although this is at an early stage and it will influence how service are provided in the future.

f)          LPT pioneered the Triage Car (mental health nurse accompanying a police officer) which had now been used as a national model.  The Triage Care showed a 33% reduction in people being detained under Section 136 of the Mental Health Act 1983.  The Triage Car had now been included in the Liaison Diversion Services.

g)         LPT had set up the recovery college and over 500 people had gone through the college and the data was being monitored and analysed.

h)        Feedback is also received for the Voluntary and Community Sector which informs the LPT on where services need to be redesigned.

i)          A workshop was being held the following week to profile demographics and to see what services should be commissioned in each of the three CCG areas.  Each CCG area had differing commissioning needs.

j)          LPT also provides some specialised commissioned services such as health care in prisons which includes providing mental health services.

k)         LPT are already rolling out the R10 system in mental health services and for older people and will shortly roll it out in the Crisis Care Team.

l)          Data can be provided on the breakdown of the workforce for the services provided.

m)        The ‘Smoothie Project’ involving music, drama and DJ skills for young black patients had produced tangible health benefits for those involved.  A briefing note would be supplied after the meeting.

In response to Members questions, the following responses were received:-

a)         It would take further work to look at the existing data to see if it was possible to make comparisons or show trends at national, regional and local levels for the three main mental health illnesses suffered by young black men in relation to the population as a whole.

b)         LPT takes part in national data benchmarking but it does not go down to lower levels as there is no specific key performance indicator for mental health involving BME communities.

c)         In some instances the Police are unaware that  ...  view the full minutes text for item 11.

Guidance for Commissioners of Mental Health Services For People From Black And Minority Ethnic Communities issued by the Joint Commissioning Panel for Mental Health is attached for information.

The ‘Guidance for Commissioners of Mental Health Services For People From Black And Minority Ethnic Communities’ issued by the Joint Commissioning Panel for Mental Health had previously been circulated and was received as background information for the review.

The Chair declared the meeting closed at 7.30 pm