Erville Millar, Chief Executive, Kent and Medway NHS and Social Care Partnership Trust and Lauretta Kavanagh, Director of Commissioning for Adult Mental Health Services and Substance Misuse, Medway PCT will be in attendance for this item.
Minutes:
(Item 4 – Mr E Millar, Chief Executive, Kent and Medway NHS and Social Care Partnership Trust, Ms L Kavanagh, Director of Commissioning for Adult Mental Health Services and Substance Misuse, Medway PCT, Mr O Mills, Managing Director, Kent Adult Social Services, and Mr P Absolon, Social Care Commissioner for Mental Health, were in attendance for this item)
(1) The Chairman apologised on behalf of the Committee for the lack of time that Health Service colleagues had been given to respond to the questions they had been sent on mental health.
(2) Mr Millar and Ms Kavanagh gave presentations on mental health services in Kent (attached to these minutes as Appendices 1 and 2) and answered questions from Members:-
(a) NHS colleagues explained that if a person was already known to the Crisis Resolution Home Treatment (CRHT) service then the service could be accessed directly by a person such as the carer or partner of a service user.
(b) Members expressed concern about access to out-of-hours services by both service users and carers. NHS colleagues stated that there were clear pathways regarding access to out-of-hours services. As requested previously by the Committee, they were working on a plan regarding access to out-of-hours services by people with less severe conditions. This would be made available to the Committee, and other stakeholders, soon.
(c) Concern was expressed by Members about whether the CRHT service was actually available 24 hours a day. NHS colleagues stated that the service was available to those who needed it, namely people with serious long-term conditions.
(d) NHS colleagues explained that the commissioning budget for mental health services in Kent did not include services for people whose primary problem was one of addiction. Substance misuse services were commissioned through the Kent Drug and Alcohol Action Team, a multi-agency partnership led by KCC, which had its own commissioning budget.
(e) NHS colleagues explained that there was an established process within the NHS for dealing with complaints about services; KCC also had its own complaints mechanism. In addition, there was an ongoing dialogue with carers and service users, allowing them to raise issues of concern.
(f) Members asked about the National Survey of Investment in Mental Health Services, which had shown that Kent and Medway was at the bottom of the national league table for investment in mental health services in 2005–6. NHS colleagues responded that this financial mapping exercise had concealed differences within Kent and Medway – investment in East Kent had been in line with the national average; but in West Kent and Medway it had been below the average. The results of the mapping exercise for 2006–7 could not be directly compared with those for 2005–6, as the exercise was carried out at Strategic Health Authority (SHA) level, and Kent and Medway SHA had ceased to exist in 2006, when it was merged into the new South East Coast SHA. Further data for the mapping exercise had been submitted in December 2007 and this would be shared with the Committee.
(g) NHS colleagues stated that they sought to work with service users and carers as much as possible. They had a Carers’ Charter; and service users and carers were involved in the commissioning of services.
(h) It was confirmed that the CRHT service was provided by multi-disciplinary teams, including consultant psychiatrists.
(i) It was stated that, in some parts of Kent, A&E mental health liaison nurses were employed, with access to CRHTs to make an assessment of a patient if necessary.
(j) It was confirmed that there were identified police mental health liaison officers, who acted as a point of contact between the police and mental health services.
(k) The importance of both police and ambulance service personnel getting adequate and consistent training to deal with people with mental health issues was emphasised.
(l) NHS colleagues said that the SHA had granted the Partnership Trust authority to proceed with a three-month consultation about applying to become a Foundation Trust and this would commence straightaway.
(m) Members felt that there was a need for more specific proposals for young carers. The Director of Kent Adult Social Services referred to the recently published Young Carers Strategy “Invisible People”.
(n) Members stated that there should be support for carers and families of service users to help them to continue to cope. The importance of carers having assessments of their own needs was emphasised.
(o) Ms Kavanagh undertook to come back with figures on the number of cases dealt with each year and how many NHS employees were involved in handling those cases. The commissioning teams were developing a five-year commissioning strategy; this would have figures on levels of need and how this was evidenced, and on what the take-up of services was.
(p) Members thought that information on how to go about accessing emergency support needed to be made more readily available.
(q) NHS colleagues explained that they were committed to developing services for early intervention in psychosis.
(r) It was explained that there was a healthy advocacy service in Kent; and the recent Mental Health Act would mean there would have to be increased investment in advocacy.
(s) The provision of services for children was raised; it was explained that these services were separately commissioned by the Children’s Trust.