Minutes:
(Mrs E Green, Mr J F London, Mr G Rowe, Mr R Tolputt and Mrs E Tweed were present for this item)
(Mr M J Angell declared a non-pecuniary interest as a Non-Executive Director of the Trust, and Mr S J G Koowaree declared a non-pecuniary interest as a mental health worker employed by an agency which is used by the Trust)
(1) Mr Smallridge presented a series of slides which set out the Trust’s progress towards its bid for Foundation Trust Status, how its organisation would change as a result of a bid being successful and how the change would impact upon KCC’s relationship with the Trust. Members had also been sent the Executive Summary of the Trust’s Integrated Business Plan. The slides used in the presentation are attached to these Minutes at Appendix 1.
(2) Arising from the presentation, and in Mr Smallridge’s responses to questions put by Members, the following points were highlighted:-
(a) the Trust’s services would be delivered both directly, using its own premises, and indirectly, via the PCTs’ commissioning process. Using a range of premises and shared sites allowed the Trust maximum flexibility in the services it could deliver;
(b) one in six adults of working age in the UK experienced mental health problems of some sort, and the stigma surrounding anyone with mental health issues who was trying to stay in, or re-enter, the workplace was a major problem to be addressed. Part of the Trust’s work included an Employability thread;
(c) the Trust would be steered (not run) by a Council of Governors, which would include elected representatives of the Trust’s 1,500 public membership. The aim was to achieve a range of experience and skills on the Council of Governors. The Trust sought to increase its 1,500 membership, and any member of the public could apply to join;
(d) the Trust currently scored a level 2 in the Healthcare Commission’s Auditors’ Local Evaluation (ALE) ratings and was aiming for a score of 3, which it needed to achieve to be accepted by Monitor.
(e) the Trust’s income would be allocated and set for three years at a time so there would always be some degree of estimation of costs for three years into the future. Data upon which estimates could be based had been poor in the past but was improving;
(f) although the aim was to move patients to short stay as far as possible and maximise the number of patients moving from long stay into the community, there would always be a need for some secure accommodation for those with severe mental health needs. Good rehabilitation services were key to achieving shorter stays and moves into the community;
(g) the figure of 28,000 current service users stated in the slides covered all outpatients, long stay patients and people with dementia, whether in hospital or at home. The recent King’s Fund report “Paying the Price” had predicted a 14% increase in people needing mental health services, with the largest increase being in Alzheimer’s and dementia patients in primary and secondary care. Mr Mills added that the number of people with dementia was predicted to increase by 61% over 20 years at a cost, nationally, of £9bn. Only one third of people with dementia were known to be receiving services which related to their condition;
(h) it was not known how many of the 1,500 public members were patients with mental health needs, but Mr Smallridge said he expected the public representation to reflect the ratio of one in four of the main population having mental health needs. He emphasised that patients were not excluded from being members of the Trust, or from standing for election to the Council of Governors, but that, at the particular request of patients, no special forum had been established solely for patients;
(i) the Trust provided services to young people and adults in custody. In Young Offenders’ Institutions the Trust contributed the services provided by the Prison Service;
(j) the Trust would like to see greater priority being placed on CAMHS for children and young people, particularly by increased investment at tiers 3 and 4; and
(k) patients now had more choice and influence over their care packages, except for those who had been sectioned under the Mental Health Act, and those in prison.
(3) Mr Mills pointed out that the Trust’s move to Foundation Trust status constituted a very important change to the way KCC delivered mental health services in line with its statutory duties. This proposal offers major opportunities for service users and the local community to exercise more influence over the many metal health services KASS provides and improve local accountability. Services for people with learning disabilities currently living in NHS accommodation provided by the Partnership Trust in the West of the county will become the responsibility of KCC. This is a complex process, which is being carefully managed with the full participation of both KMPT and PCTs.
(4) The status of the 300 KCC staff currently seconded to the Trust was raised. As a good employer, KCC remains fully committed to them and they will remain seconded whilst the Foundation Trust application is made. Any proposal to change their status would not be considered until the new organisation is fully bedded down and any proposed change would be subject to full consultation with staff and the recognised trade unions.
(5) RESOLVED that the information given in the presentation and in response to questions from Members be noted and welcomed.