Agenda item

The Chairman invited Neil Snee, Interim Director of Commissioning, Barnet CCG, and Dr. Charlotte Benjamin, GP Board Member, Barnet CCG, to the table.

Dr. Benjamin provided the Committee with details of the work that had been undertaken in relation to the development of mental health care including the following points:

·        In 2014, Barnet CCG and the London Borough of Barnet separately reviewed their Mental Health services. The key findings of both reviews highlighted:

- The lack of effective crisis planning and community services

- The lack of “early intervention for wellbeing” approaches

-  More calls to work in partnership in the community

-  The need to use resources more effectively

·        From May 2015, Barnet CCG undertook a full engagement and consultation process with statutory providers, voluntary sector providers, people with “lived” experience and wider stakeholders to ‘reimagine’ mental health provision within a phased approach focussing on:

-       A co-production model to deliver better, more targeted health and social care services through a community–based approach;

-       Directing resources more appropriately through better collaboration between all organisations

-       Continued involvement of people with mental health needs and their carers as a key to shaping future services

·         Extensive consultation was undertaken in transforming Mental Health services through a series of Co-design “Breakfast Clubs” and action learning Trailblazers with people with “lived” experience of mental health problems, the voluntary sector, the statutory sector including Public Health/ Barnet Enfield and Haringey MHT, as well as many others.

·         A Needs Assessment was then undertaken with expert colleagues from UCL, which allowed for the determination of a vision for more integrated mental health provision in Barnet and to support commissioning intentions to deliver pathway remodelling as part of the programme.

Dr. Benjamin advised the Committee that she was very pleased with the new way of working with patients and noted that the challenge was the need to extend the system to the West and North of the Borough. The Committee noted that Dr. Benjamin wished for social workers to be embedded within the model.

A Member questioned the impact of the programme on younger and teenage patients.    Mr. Snee replied that although the model being presented to the Committee was an 18 plus model, the Health and Wellbeing Board had recently received a paper on the Tier 4 service which highlighted the pressure on young people.

Dr. Benjamin informed the Committee that the model was evidence based and therefore not “new”. She noted that it was strategically very difficult for a Trust to change its way of working in one go, which was why it was decided to undertake the pilot in smaller parts of the Borough as opposed to borough wide.

A Member questioned if the model worked as a partnership. Dr. Benjamin advised the Committee that the model was very much about partnership working and that she felt that colleagues were unaware of the potential resources in Barnet. She added that previously it could take weeks to refer a patient to appropriate services, during which time the patient could deteriorate. Dr. Benjamin commented that the approach was about the patient being seen at the right place and at the right time.

Mr. Snee informed the Committee that he had been very impressed with how the team had brought together available resources and looked at what was available and that the prospect of working with Local Authority colleagues and bringing social workers into the model was very exciting.  In many ways, the model was more a social model than a clinical one.

A Member referred to a section of the report which noted that “for example, in Camden, complexity accounts for greater use of the highest cost services than in Barnet, but where the investment nearly doubles across all modalities” and questioned what this meant in practice.  Dr. Benjamin advised the Committee that Barnet and Camden were very different areas, with different needs and that whilst Camden invests more, the outcomes aren’t necessarily better. 

A Member commented that the Committee had been invited to visit the Dennis Scott Unit earlier in the year and that it had made her realise the importance of patients being seen quickly and that the implications of a patient having to wait for treatment could be extremely serious. 

A Member commented that often people with mental health issues can be upset by the lack of sympathy with their condition, especially when combined with the stigma around mental health issues.  Dr. Benjamin advised that experts would be used to provide training and that patients and service users would be consulted on their views concerning the most appropriate training.

Responding to a question from a Member on the difference between services for those with mental health issues and for those with learning disabilities, Dr. Benjamin advised that the two were distinct, but there could be an overlap in certain cases.  The Committee noted that the CCG had identified Autism as an area for improving the Barnet offer. 

RESOLVED that:

1.    That the Committee noted the current development and possible future developments set out in this paper - Reimagining Mental Health: Exploring Solutions Together;

2.    That the Committee noted the commitment from all partners to support transformation of mental health pathways;

3.    That the Committee supported the ongoing commitment from stakeholders to continue to develop a dedicated model for sustainable service improvement in mental health pathways to well-being;

4.    That the Committee offered comments on the recommendations for the continued development.

The Chairman announced a variation in the agenda, with the Health Tourism item being considered next.