Ms Val McGee, Deputy Director of Operations – Cheshire and Wirral Partnership NHS Foundation Trust and colleagues provided a written report and gave a presentation updating on the Cheshire and Wirral Partnership NHS Foundation Trust (CWP) Community Mental Health Service Redesign.

The report provided an outline of the forthcoming consultation on the proposed changes to trust-wide community mental health services provided by Cheshire and Wirral Partnership NHS Foundation Trust.

Ms McGee indicated that the CWP were proposing to introduce the ‘Stepped Approach to Recovery’ (StAR). This model had emerged as the preferred model of service delivery following an assessment of a number of alternative models in use nationally, and consideration of the outcomes of the various stakeholder engagement and improvement events held earlier in 2012.  The assessments and events identified that improvements were required in respect of access to services; enhancing the focus on recovery and making more effective use of staff resources.

Ms McGee indicated that the StAR model was firmly based on the concept of recovery, already adopted across CWP focused on enabling a person’s recovery as they progress through the pathway. If approved, the proposed changes would have a significant impact on the way the community mental health service met the needs of service users in the future.

The model focused on:

• Recovery, health and well-being – to include new well-being centres and nurse-led clinics
• Community teams structured in line with a stepped approach to recovery care pathway: ‘Access’, ‘Recovery’, ‘Review’
• Matching the staff skill required with the needs of our service users; and wherever possible by people working in multi-disciplinary teams around individuals and their families
• Local variation to meet local needs (rather than a rigid model, local areas can adapt the model to meet the needs of local people)
• Evidence based interventions – this includes psychosocial interventions, cognitive behavioural therapy, individual counselling and family work aimed to deliver positive outcomes and demonstrate value for money
• Care Programme Approach - this was the framework which supported individual care, promoting social inclusion and recovery

The report indicated that the proposed changes to trust-wide community mental health services would go through consultation with both the public (running for three months from September 10th to December 3rd 2012) and with affected Trust staff (for three months starting 3rd October 2012). The public consultation would seek feedback from service users, carers, our foundation trust membership and partner organisations. The outcomes of the consultations would inform decisions on the way forward and subsequent changes will be implemented from January 2013.

The review was part of the NHS efficiency saving requirements, of which the Trust had to achieve over £13m of savings over the next three years. The review of the community mental health service was part of the process, and was in keeping with CWP’s earlier consultation where support was received for redesigning care pathways and new ways of working (for example nurse-led clinics) in the public consultation in 2010: “Developing high quality services through efficient design.”

The scale of the proposed changes was such that the staff employed within the service would be reduced and new ways of working introduced. Measures would be taken to reduce the need for any compulsory staff redundancies. Ms McGee indicated that it was hoped that the reduction in staffing would be covered by voluntary redundancies and staff redesignated throughout the Trust. Discussions with affected staff would continue into December 2012.

The public consultation on the proposed changes would take several forms. This would include a paper based document and questionnaire, an on-line questionnaire, and a series of public meetings held locally. Invitations to these would be extended to anyone with an interest in the developments. The meetings would be hosted and attended by senior officers from the Trust who would present an overview of the proposed changes, and would answer any arising questions and queries.

The local meeting for Wirral would be held on Wednesday 7th November, 10.30am at The Lauries Centre, 142 Claughton Road, Birkenhead, Wirral CH41 6EY.The full consultation document would be circulated to committee Members on Monday 10th September.

In response to Members Ms McGee indicated that saving would be made by having less acutely ill patients, a reduction in staffing levels and changes made to the assessment process.  

In relation to evidence, Ms McGee indicated that a lot of research had been undertaken and evidence gathered and integration work completed to support these proposals. It was hoped that the consultation would tease out where services were lacking.

Ms Chris Beyga, Head of Personal Support, Adult Social Services indicated that the Director of Adult Social Services would be responding on behalf of the Authority.

 Dr Abi.Mantgani indicated that a lot of work had been undertaken in the past in relation to creating a single point of contact and improving access to services for patients. He indicated that he shared the Council’s concerns regarding the lack of consultation but felt this was an issue to be discussed by the CCG and members of the Committee to agree a way forward.

In response to Members, Ms McGee indicated that in relation to day care services there were no plans to dispose of the service which was run by the Authority.

In relation to the Joint Scrutiny Committee with the CWP Ms McGee indicated that she was aware of the discussions regarding the continuation of the Committee however no issues had been resolved.

Resolved - That

(1)  the report regarding CWP’s approach to the Community Mental Health Service Redesign public consultation commencing in September 2012 be noted ; and 

(2)  Ms Val McGee and colleagues be thanked for their informative report and presentation.