Agenda and minutes

No declarations of interest were made.

The Minutes of the extraordinary meeting of the Scrutiny Committee held on 19 September 2012 at which the parameters of the Mental Health Review were agreed are attached for information.

RESOLVED – That the Minutes of the previous extraordinary meeting held on 19 September 2012 be noted.

The Service Director (Adult Social Care) and the Commissioning Manager, Mental Health (Stockport Council) will attend the meeting to provide an overview of mental health provision available in the community, including innovative approaches to people powered health and peer support.

(i) Terry Dafter (Service Director (Adult Social Care)) and Nic Dixon (Commissioning Manager for Mental Health, Drug & Alcohol Services), Stockport Council, attended the meeting to make a presentation on community-centred approached to mental wellbeing and recovery.

An information note setting out background information in relation to co-production in mental health pathways was also submitted (copies of which had been circulated).

The presentation covered the following issues:-

Background

·         Resources were skewed toward acute care and clinical approaches to mental illness. Users were in danger of being ‘warehoused’ in acute settings.

·         Emphasis needed to shift toward recovery that was focussed on sufferers ‘getting their life back’ rather than entirely overcoming illness or symptoms.

Outcome Focus – ‘getting life back’

·         Personalisation, handled properly, was more effective at ensuring a focus on outcomes for sufferer.

·         Getting a life back recognised the importance of a sufferer’s community setting, as well as empowering them in their treatment.

·         Shift from the ‘Professional Gift’ model to ‘Citizenship’ model.

·         Shift of resource from the intensive and costly treatments by discouraging people from entering acute services unless absolutely necessary.

·         Strong evidence that co-production delivered improved outcomes for less cost.

NESTA Project

·         Stockport had a track record of success in innovative mental health treatments through support for co-production and community-based approaches. Through attracting NESTA funding it was possible to widen the scope of smaller projects to support a programme of transformation of treatment for long-term conditions, based in Brinnington.

·         The aim of the project was to prevent the escalation of conditions while reducing the severity of conditions in other users.

·         Evidence from Brinnington GPs was that the number of referrals and repeat appointments had reduced.

Barriers to community based approaches

·         Paternalistic approach of acute care – once in the system it was difficult for sufferers to get out.

·         ‘Payment by Results’ disincentivised discharge and alternative treatments.

·         GPs were not necessarily empowered and skilled to make referrals to community-based or co-produced treatment alternatives.

·         Patients and carers – may have had to battle to get into the service so resistant to change.

Benefits of Co-Production

·         In financially restricted environment, Peer Support provided an effective and low-cost opportunity for expanding provision.

·         An opportunity to explore ‘Time Banking’ to tap into community/ volunteering/ peer support assets.

·         Savings could be reinvested while simultaneously improving outcomes.

·         Impact on other services, i.e., fewer hospital admissions, reduced benefit claims

·         Building community capacity through volunteering for peer support.

·         Peer Support provided hope for sufferers.

(ii) Shirley Dean (Chair, Stockport User Friendly Forum (STUFF)) and Jackie, a peer supporter, attended the meeting to provide an overview of their work in co-production and peer-support.

The following issues were highlighted:-

Background

·         The National Framework sought to put users and volunteers at the centre of decision-making about commissioning.

·         STUFF worked collaboratively with commissioners (Council), providers (Pennine Care NHS Foundation Trust) and other voluntary sector organisations (Stockport MIND) in providing support and training.

Challenges

·         Small voluntary organisations struggled with tendering processes.

·         Overcoming user’s reliance and feelings of security in service ‘warehouses’ which often did not address underlying causes of mental illness.

·         Empowering users to have confidence in making decisions about their own treatment and support.

Benefits

·         Co-production put the user/ sufferer at the centre, and recognised the value of their wider support network, be that family or people in the community.

·         Peer support had benefits for both those coming into the service but also for those volunteering as it allowed them to use negative experiences for a positive purpose. Volunteering often provided a stepping stone for work.

·         Users often stressed the value and importance peer support had in their recovery.

Members of the Committee then discussed the presentations and the following issues were raised/ comments made:-

·         Collaborative working between commissioners, acute providers and the voluntary sector was providing opportunities for innovation.

·         The work of the ‘NESTA project’ was extremely positive and provided a route toward more radical approaches to treatment and care.

·         It should  ...  view the full minutes text for item 3.

RESOLVED – That consideration of this item be deferred.