Agenda item


To consider a report from Northumbria Tyne and Wear (copy to follow).


The Committee received a presentation from representatives of Northumberland, Tyne and Wear NHS Foundation Trust (NTW) regarding the future mental health service provision in north Cumbria. 


Members received a general overview of NTW and were informed they were working with partners to redesign their mental health primary care model.  It was explained that funding had already been secured for the Psychiatric Liaison and Crisis and Home Based Treatment services and that enhanced bed management to reduce out of area placements had already been introduced.


The Committee was informed that to date the Learning Disability pathway was being reviewed and improved, the rehabilitation pathway was being reviewed and redesigned and there were significant improvements already in place in Child and Adolescent Mental Health Services (CAMHS) with an improved partnership with Lancashire Care Foundation Trust (LCFT). 


A discussion took place regarding the workforce and it was noted that Cumbria Partnership NHS Foundation Trust (CPFT) and NTW had a joint recruitment process in place for nurses, employing five nurse consultants and developing non?medical roles.  It was noted the first cohort of nursing apprenticeships were scheduled to begin in January 2020.


A concern was raised regarding workforce training and the lack of skilled people.  It was suggested and acknowledged by officers that upskilling trained staff would be a positive move.  A specific concern was raised regarding experienced specialist qualified youth mental health workers in schools.  It was explained that NTW had responsibility for training mental health support workers in schools and colleges and this could be transferred across once funding was agreed.  It was agreed that NTW would meet Mrs Hanson separately to discuss this matter further.


The Committee was informed of a number of key drivers which had been identified in 2018 which included waiting lists, lack of electronic waiting lists, recruitment and retention issues, poor rate of service user and carer feedback and engagement, staff wellbeing and involvement and high levels of sickness and poor retention rates.


A discussion took place regarding the RIO system which was an advanced electronic care patient record system which NTW currently used.  It was acknowledged that Cumbria would benefit from a similar system.


Members were informed that since 2018 children and young people waiting for treatment had significantly reduced and the locally agreed standard was that 90% wait no more than 48 hour from referral to first contact for urgent appointments.  It was explained an electronic waiting list was now in place and was reviewed weekly by CAMHs managers and staff. 


The Committee was informed that NTW had commissioned to provide a Monday to Friday, 9 am to 5 pm service whilst acknowledging that a more comprehensive service was required.  It was felt there was a need to develop a home treatment service and enhance a community service.  The importance of engaging with primary care, including GPs was essential to ensure that people were signposted to the correct service. 


A discussion took place regarding the problems incurred, including vast amount of wasted time, for GPs to access an approved social worker in Cumbria.  Whilst acknowledging the challenges it was explained that NTW were not responsible for health care practitioners and this was the responsibility of the Local Authority.  It was agreed that an invite to a future Working Group would be extended to Dr Hanley to discuss this matter further.


The Committee welcomed some of the achievements to date which included the increase of young people who had a co?produced care plan, a proactive strategy and action plan for service user and carer engagement in place, staff wellbeing, reduction in sickness and absence and reduction in agency and vacancies. 


Whilst members welcomed the improvements which had been made they also recognised the challenges they still faced which included demand growth outstripping capacity which resulted in longer waiting times than they wanted, workforce gaps, age profile of some senior leaders and difficult commissioning arrangements.


The Committee raised their concerns regarding the high suicide rates in Cumbria   It was explained that the Suicide Prevention Strategy would be considered in future by all key partners and third sector organisations.  It was agreed that delivery of the Strategy would be included on the Joint Health and Adults Advisory Group work programme.


In conclusion, NTW outlined opportunities going forward which included bringing people together as a key early priority, understanding what worked in the unique geography of Cumbria and building on it, sharing what was really good across the newly formed organisation and what the greater critical mass could bring.


The Chair thanked officers for their update and asked that the Committee receive a further report in future.


RESOLVED,   that


                          (1)          the update be noted;


                          (2)          NTW would meet separately with Mrs Hanson to discuss mental health support in schools and colleges;


                          (3)          NTW be invited to the Lead Health Scrutiny Member meetings with North Cumbria System Leads;


                          (4)          delivery of the new Suicide Prevention Strategy be included on the work programme for the Joint Health and Adults Advisory Group.

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