Agenda item

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 was £327,000 and that this was the figure in the Trust’s published accounts.  It was also stated that the use of consultants was often necessary for limited periods and/or for specific purposes because the Trust could not justify directly employing these specialists when they would be under capacity.

·         Many of the points made in the earlier presentations were not disputed; it was also the case that the current model of provision was not sustainable with the same level of resource as demand was rising. It was also recognised that the current period of austerity was stressful to the public and service users.

·         Concerns raised in relation to inappropriate discharges from hospital would be shared by the Trust.

·         The proposals in relation to new service models were currently out for consultation.

Dr Ranjit Gill (GP and Chief Clinical Officer, Stockport Clinical Commissioning Group) and Mark Chidgey (Director of Quality & Provider Management, Stockport Clinical Commissioning Group)

·         The CCG had met with the SAMHC on previous occasions and was aware of their concerns.

·         The CCG recognised that there had traditionally been underinvestment in mental health services, as part of the general imbalance in spending toward hospitalised services for physical ill-health.

·         Many of the people making representations had severe and enduring mental illness, and they had specific needs, but that the CCG had to consider all the needs of people in the area.

·         The CCG recognised the concerns raised by SAMHC in relation to proposed budget reductions and new service delivery models, and was in ‘listening mode’.

·         The decision on these changes would be taken by the CCG Governing Body at its meeting on 10 December 2014, in conjunction with the Equality Impact Assessment.

Nick Dixon (Commissioning Manager, Mental Health and Substance Misuse, Stockport Council)

·         Comments made about recovery focussed activity/ people powered services were welcomed. It was emphasised that this was a new approach, but it was important that it be developed collaboratively with service users.

·         Previous comments about fragmented services were echoed, and it was recognised that these created potentially dangerous gaps in services.

The following comments were made by members of the Scrutiny Committee:-

·         The recognition of underfunding was welcomed, as were the assurances that the CCG was listening to the concerns of service users and carers.

·         The vulnerable needed to be protected, but smarter ways of working were also needed to be able to work with limited, and reducing, resources.

The Chair expressed sympathy to the concerns raised at the meeting, and stated that the Scrutiny Committee recognised that mental health spending overall was insufficient to meet the needs of population. The Chair also referenced previous reviews undertaken by the Scrutiny Committee in relation to mental health.

The Chair also recognised that there were financial challenges to both the PCNHSFT and the Stockport CCG, but that the CCG had committed to investing in prevention. He stressed the danger that if the CCG and PCNHSFT did not take timely decisions then less appropriate changes may be forced upon them in the future.

In relation to a question from the public, the Chair stated that the Scrutiny Committee would seek to monitor the impact of changes and would revisit the issue in 12 months’ time.

RESOLVED – That Stockport Against Mental Health Cuts Group, other members of the public, and the representatives of the Stockport Clinical Commissioning Group and Pennine Care NHS Foundation Trust be thanked for their attendance and representations.

[Note: Following the meeting the Chair wrote to the Chairs of the Stockport Clinical Commissioning Group and the Pennine Care NHS Foundation Trust setting out the concerns raised at the meeting]