The panel received a report on proposed changes to Mental Health Recovery Pathways.  David Macaulay, Mental Health Services Manager PCH introduced the consultation document, it was reported that –

(a)   the paper set out proposals to redesign recovery services in the city in order to deliver improved outcomes and efficiencies through a programme of investment in community alternatives and inpatient treatment;

(b)  Plymouth had significantly more Recovery in-patient beds when benchmarked against comparable Mental Health Providers;

(c)   a programme of re-distribution of resources and service re-design would improve the quality of service and release resources for further investment;

(d)  the proposal was aligned with the national direction of travel and national best practice;

(e)  through developing community alternatives to in-patient care and strengthening working arrangements with Supporting People colleagues, 3,000 bed days could avoided;

(f)    the total number of current delayed discharges equated to the capacity of either The Gables or Syrena in-patient units and marginal improvements in the period of time patients spend within these units would yield a significant reduction in the need for in-patient beds;

(g)   the redesign would enhance the ability to meet the complex needs of people within the community;

(h)  it was hoped that the redesign would achieve the following outcomes –

·         A reduction in the need for out of area placements through a more effective model of service delivery and without compromising the ability to meet existing local demands.

·         The delivery of services closer to people’s homes and communities.

·         Services developed in response to identified individual needs.

·         A model developed in collaboration with people who use services and carers as well as with clinical involvement and input.

·         The provision of better clinical outcomes for people.

·         The delivery of significant efficiencies and an opportunity to re-invest in areas that are known deficiencies.

In response to questions from panel members, it was reported that –

(i)    community services would be enhanced to provide support people administering their own medication;

(j)    the patients who would be affected by the redesign were not deemed high risk and were on the pathway to independent living;

(k)  efficiencies savings made as part of the process would be reinvested into mental health services and there was no risk of money leaving the sector;

(l)    changes in the welfare system could lead to increased levels of stress amongst the population, although these issues had been considered the client group affected by the redesign were different as they had a diagnosis of psychosis;

(m)the Primary Care Trust was aware that agencies required help with dealing with instances of severe depression within the population and the demand for swift action for those with that need, commissioners continued to carefully balance the system ensuring that specialist areas were adequately resourced;

(n)  there were a range of services available to help those with learning disabilities and mental health needs gain meaningful employment. Services included ‘Steps’ and some services provided by Plymouth Community Healthcare.  There was a wide range of responses that agencies had available;

(o)  with the client group affected by the proposal there was a high risk of suicide, each individual user had a risk assessment to mitigate risk and there had not been a suicide for a number of years. The transfer from in-patient unit into community was high risk and the transition took place if appropriate with a focus on the individual.

(p)  support would be provided to General Practitioners ensuring a development of knowledge and skill base in relation to this client group;

(q)  the development of a model which would retain the single sex facilities is a high priority and providers were optimistic that this model could be achieved;

(r)   there was capacity in the system for beds to be used during transition.

Agreed that –

(1)  the panel receive a progress report in three months which would include a focus on the Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis, Skills analysis and single sex facilities;

(2)  a project plan would be circulated to members.