Issue - meetings

To consider an update from the Chair on further development with the referral from Healthwatch Stockport to the Secretary of State raising concerns about possible reconfigurations to mental health services in Stockport.

The Chair updated the Scrutiny Committee in relation to a letter sent by Healthwatch Stockport to the Minister of State for Care and Support raising concerns about the perceived lack of public consultation on the proposals for changes to mental health services announced by Pennine Care NHS Foundation Trust (Minute 6 of 24 February 2015 refers).

The Chair reported that since the last Scrutiny Committee meeting he had met with senior management of Pennine Care NHS Foundation Trust to discuss the concerns raised by the Healthwatch Stockport, who had also planned to meet the Minister of State. The matter had also been raised at the Joint Scrutiny Committee for Pennine Care.

The Chair was aware that a response had been sent to Healthwatch from the Minister and that when a copy was made available to him the Chair would ensure it was circulated to members of the Scrutiny Committee.

RESOLVED – That the report be noted.

(Note: the Chair was of the opinion that this item, although not included in the agenda, should be considered as a matter of urgency in accordance with Section 100B (4) (b) of the Local Government Act 1972 in order that the Scrutiny Committee could consider the matter promptly.)

The Chair reported that he had received a copy of a letter sent by Healthwatch Stockport to the Minister of State for Care and Support requesting a full public consultation on the proposed changes to mental health services announced by Pennine Care NHS Foundation Trust. Healthwatch had raised concerns about the perceived lack of public consultation on the proposals.

The Chair further reported that he had requested an update from Pennine Care on this matter and that he would report back to the next meeting with any further developments.

RESOLVED – (1) That the report be noted.

(2) That the Democratic Services Manager be requested to circulate to members Scrutiny Committee a copy of the Healthwatch letter to the Minister of State regarding mental health service changes.

Representatives of Stockport Against Mental Health Cuts have asked to address the meeting in relation to the proposed reductions in community mental health services in Stockport.

Officer contact: Jonathan Vali, 0161 474 3201, jonathan.vali@stockport.gov.uk

Representatives of the Stockport Against Mental Health Cuts Group (SAMHC) attended the meeting to address the Scrutiny Committee in relation to their objections to proposed reductions in mental health budgets in Stockport and changes to service delivery models. A written submission from the Group had also been provided (copies of which had been circulated).

The following people addressed the Scrutiny Committee and their representations covered the following issues:-

Sandy Broadhurst (Stockport Against Mental Health Cuts Group)

·         Residents she had spoken to had opposed reductions in mental health services and privatisation of the NHS. She called on the Scrutiny Committee to listen to the views of residents.

·         Politicians had talked about establishing parity between mental health and physical health but the proposed budget reductions by the Pennine Care NHS Foundation Trust did not accord with that ambition.

·         Professionals had also expressed the view that the proposed cuts would be damaging to services and the residents they served.

·         If the proposed level of cuts were to be made to services such as cancer treatment there would be a public outcry, which further demonstrated the disparity between physical and mental health services.

·         The Scrutiny Committee was called upon to support the people of Stockport and to oppose the proposals.

Dr Robert Higgo (Consultant Psychiatrist)

·         Mental ill-health touched every family.

·         Mental health services had long been underfunded, despite clear evidence of the links with deprivation and poverty, economic challenge and premature death. This should lead to increased investment rather than less.

·         The Recovery Movement had a valuable role to play in mental health services, but could not replace other services as seemed to be the justification for budget reductions.

·         The Stockport Director of Public Health’s Annual Report emphasised the importance of mental health and the value of prevention. But prevention of mental ill-health was more challenging than other preventative activity.

·         Fragmented services subject to rapid change did not lead to good service to patients.

Joan Gibson (representing carers)

·         Carers were not in support of the proposed reductions.

·         20 years of underinvestment in mental health services should not be compounded by further cuts.

·         Carers already faced real challenges, and the proposed changes were worrying to them.

·         Residents would experience poorer health and wellbeing if they had poor mental health, and the proposals would result in less support for recovery, which in turn would lead to long-term challenges.

·         Carers were looking to the Local Authority and its duty of care toward this vulnerable group. While the voluntary sector provided excellent services, it would not be able to cope with the extra pressure caused by budget reductions.

·         ‘Parity’ was just a word.

Irene Harris (Rethink Mental Health Group and Stockport Against Mental Health Cuts)

·         It was the belief of Stockport Against Mental Health Cuts that the proposals would lead to the following consequences:-

-       More acute admissions

-       Greater use of the Mental Health Act powers

-       Increased use of institutional care and extra Social Care pressures and costs

-       Increased incidences of staff stress and sickness

-       Greater risk to staff and service users of untoward incidents

·         The Scrutiny Committee was urged to call on

-       the Clinical Commissioning Group to increase spending on mental health services appropriate to the needs of the population, to move toward parity with national spending levels and parity with physical health spend.

-       Pennine Care NHS Foundation Trust to not cut services when they were spending £1.2m on consultants.

The Chair then invited representatives of the Pennine Care NHS Foundation Trust (PCNHSFT) and Stockport Clinical Commissioning Group (CCG) to respond to the issues raised.

Stan Boaler (Mental Health Service Director, Pennine Care NHS Foundation Trust)

·         Clarification was provided in relation to the Trust’s spend on consultants. It was stated that the figure of £1.2m quoted had been provided by the Trust in response to a Freedom of Information Request but that further investigation had revealed that the actual figure  ...  view the full minutes text for item 4

This item has been placed on the agenda at the request of the Chair.

Representatives of Stockport Clinical Commissioning Group, Pennine Care NHS Foundation Trust and Unison have been invited to the meeting to discuss future plans for mental health services.

Officer contact: Jonathan Vali, 0161 474 3201, jonathan.vali@stockport.gov.uk

This item had been placed on the agenda at the request of the Chair.

The Chair informed the Scrutiny Committee that he had been in discussions with representatives of the Stockport Clinical Commissioning Group, Pennine Care NHS Foundation Trust and Unison in relation to changes to funding and configuration of mental health services in 2014/15 and beyond. He had invited these three organisations to the meeting to outline the background to this issue.

Pennine Care NHS Foundation Trust

Stan Boaler, Service Director for Mental Health (north and south) stated that feedback from stakeholders indicated that current service provision was not meeting the needs of users. This was within the context of increasing demand for services and decrease resources. It was no longer sustainable to continue to provide services in the same way and they would need to provided differently. The Trust was already exploring opportunities for innovation to improve service delivery.

Stockport Council

Nick Dixon, Commissioning Manager, Mental Health and Substance Misuse, stated that the Council had been engaged in developing preventative services and services to support people to step-down from more intensive interventions. Co-produced services had been successful on a small scale and further consideration was being given to ‘scaling-up’ these services.

Clinical Commissioning Group (CCG)

Dr Ranjit Gill, Chief Clinical Officer, outlined some of the financial challenges facing the NHS in both the national and local context. It was stated that in comparison to other clinical commissioning groups in Greater Manchester and in the 10 closest comparators, Stockport was one of the least well funded. Health care in Stockport was also heavily skewed toward more costly hospital care at the expense of primary and community based care. The CCG was in the process of rebalancing the system away from hospital care and reinvesting resources to more preventative and non-acute provision, including mental health services. Specific, targeted investment was planned for mental health services for 2014-16.

Health & Wellbeing Board

Councillor John Pantall, Chair of the Board, emphasised the role of Board in influencing the commissioning decisions of local partners, and the recognition of the need to reduce demand for acute care to release resources for reinvestment. It was also recognised that mental health was traditionally given less priority than physical health although this was changing. The upcoming refresh of the Joint Strategy Needs Assessment would give consideration to the mental health needs of the borough.

UNISON

Angela Rayner, Stockport Branch Secretary, stated the willingness of Unison to engage with both Pennine Care and Stockport CCG to respond to the challenges facing the organisations, and welcomed the proposed Review. She emphasised the desire of members to engage with the Review to ensure the best services could  be provided. It was also stated that staff had outstanding grievances lodged in relation to workload, staffing and support and that these would need to be addressed, regardless of any other services changes.

The following comments were made/ issues raised:-

·        Members welcomed the commitment to engagement and consultation with all stakeholders and emphasised the need for genuine dialogue.

·        It was stressed that the current mental health system was skewed too heavily toward the medicalization of mental health to the detriment of community solutions and to recovery. This needed to be redressed.

·        It was important to ensure that the workforce was engaged, and that they themselves had good mental wellbeing to ensure that they could deliver change.

·        The CCG recognised that there were gaps in current service provision and in meeting the needs of particular groups, and that the CCG would be differentially investing in those services, with a focus on prevention.

·        It was stated that while the proposed CCG investment was welcomed, staff and users nevertheless remained concerned about future provision.

·        Careful consideration needed to be given to engagement with service users and the third sector, as well as the Police.

·        The concern of the Scrutiny Committee was to ensure the best  ...  view the full minutes text for item 4