Agenda item

The Mental Health Improvement Plan (MHIP) is the Surrey system’s response to the 19 recommendations of the May 2021 report “Emotional wellbeing and mental health in Surrey: A review of outcomes, experiences and services”. 

The 19 recommendations describe how we can improve the services and support which we provide to our residents and promote their mental health and emotional wellbeing.  The plan has been reset into four programmes the detail of which, with brief updates, is included in this report.

Dr Charlotte Canniff and Rachel Crossley left the meeting at 3.33 pm.

Witnesses:

Liz Williams - Joint Strategic Commissioning Convener, SCC and Surrey Heartlands (Priority 2 Co-Sponsor)

Key points raised in the discussion:

1.    The Joint Strategic Commissioning Convener (SCC and Surrey Heartlands) (Priority 2 Co-Sponsor) noted that:

-     the report outlined the progress of the four programmes and was a shortened version than that reported to the recent Adults and Health Select Committee.  

-     Early Intervention and Prevention: that was well integrated into Priority 2 as covered in items 5 and 6.

-     Bounce and Access: she was a joint SRO and had worked closely with Unity Insights on the logic model and evaluation framework to be discussed and reviewed imminently, and with the Independent Mental Health Network run by the Surrey Coalition of Disabled People who co-designed the definition of Bounce using lived experience. In terms of monitoring and evaluating impacts, programmes were being mapped to highlight any gaps.

-     Crisis and Flow: since October 2022, led by colleagues in SABP, focusing on improving flow and discharge, and admission avoidance.

-     Enablers and Culture: as with SODA, there was a commitment to having the right data and analytics, the Surrey Hackathon Project had been convened. Transformation happening outside of the MHIP, such as the NHS Long term Plan and recovery work needed to be combined.

-     there were significant gaps in projects and programme resourcing around Bounce and Access, she was solely working on that and Unity Insights would finish their work in late June; the Joint Executive Director of Adult Social Care and Integrated Commissioning (SCC and Surrey Heartlands ICS) was working with system colleagues on the matter.

2.    A Board member thanked the Priority 2 Co-Sponsor for all her hard work noting that in the absence of a mental health convener she was undertaking that role in addition to her current role. He noted that resourcing and funding was the biggest problem faced by the system and that needed to be addressed.

3.    The Chair noted that mental health funding had been slashed, she had in her former role as Chair of the Adults and Health Select Committee asked for an impact assessment but had not received it. There were also impacts on the NHS in terms of physical ramifications of not handling mental health. She stressed the need to understand the impacts caused system-wide of funding cuts to mental health; with the judiciary, other organisations and the third sector having to face the consequences. She welcomed partners being able to supply that information to explain the full impact of not properly resourcing mental health. A Board member responded that in the health arena plans sent to NHSE were being finalised, any changes in programmes of work would go through equality impacts analysis, an aggregate form of that would be provided to the Board.

4.      The Chair noted that in taking an amount of money from a cohort not being serviced for their mental health issues, asked whether someone was doing an assessment of the likelihood of those individuals to appear in another part of the system and for example the police having to address the impacts. A Board member noted the difficulty in ascertaining the secondary and tertiary impacts however noted that the system was providing targeted support for example through the ‘Right Care, Right Person’ national model, to ensure that the best agencies support someone in distress. An enhanced mental health offer in acute care in the operating plan had been approved, to come into fruition in due course; with other initiatives scheduled for future financial years. 

5.      The Chair emphasised that the indirect consequences were expensive in terms of cost but also impacts to individuals and their lived experiences, communities and organisations. She reiterated that there should be a proper attempt at an impact assessment on what it means not to spend sufficient money on mental health, work was being done abroad for example. She highlighted the need for the proper funding and resourcing of Bounce and Access. The Board member noted that SABP would look to review the impacts from the schemes within that programme; he agreed that more resources would improve outcomes.

Karen Brimacombe left the meeting at 3.47 pm.

6.    A Board member acknowledged that all were under pressure financially from every angle, however he noted that there would not be a huge handout from the Government and noted that locally all must take prevention seriously and must invest in it. He suggested that the Board could have a crisis meeting with all partners on how to invest in prevention, noting that the pressures were growing annually. Action was needed now, partners needed to commit an amount of money to start making a difference. The Chair agreed noting the need to lobby for the change in the mental health funding formula. She noted that the system could not afford to not have that data on prevention spending, nor could not afford to not spend the money on mental health.

7.    Referring to the Enablers and Culture programme on page 167 under ‘Data and digital’, regarding the published JSNA chapter the Chair highlighted the sentence: ‘noted caveats that big gaps remain in the data and the chapter and SRO recommendations’ and asked whether that data was now available. The Priority 2 Co-Sponsor did not believe that data was available, she noted that officers would use SODA to fill in the gaps and use the Surrey Hackathon Project; combining data together in packs.

Mark Nuti, Graham Wareham and Steve Flanagan left the meeting at 3.51 pm.

RESOLVED:

1.    Noted the contents of this update and endorsed the proposed next steps.    

Actions/further information to be provided:

1.    The Board member (Graham Wareham) will provide the Board with an aggregate form of the finalised plans - within the health arena - sent to NHSE which would include an equality impacts analysis.

2.    The Chair will follow up her request with the Director of Public Health (SCC) for a system-wide mental health impact assessment, both direct and indirect impacts; partners to look to supply that information.

3.    The Chair will follow up the suggestion of the Board holding a crisis meeting on prevention with partners, looking at how to invest in it to make a difference.