LOTHIAN NHS BOARD PAPER 15 Edinburgh Community Health Partnership 15 th October 2008 General Manager Edinburgh Mental Health Implementation Plan2008/09 1. Purpose 1.1. The purpose of this report is to update the sub committee on the mental health implementation plan. SUMMARY This report updates the sub committee of progress with the Edinburgh mental health implementation plan including: 24/7 emergency assessment, home treatment and crisis resolution Continuing development of Community Mental Health Teams (CMHTs) & Primary Care Liaison Teams (PCLTs) and wider community mental health networks, including the voluntary sector Development of psychological interventions Enhancement of accommodation and support services Continuing development of rehabilitation services 2. Recommendations 2.1. The sub committee is recommended to: 2.2. Note progress with implementation. 2.3. Agree to receive a more detailed report at the December 2008 meeting on the implementation of the Mental Health Assessment Service, The Intensive Home Treatment Team and the Community Mental Health Team/Primary Care Liaison Team Review. 3. Summary of Issues 3.1. Appendix 1 provides an update on implementation on the key aspects of the plan. 3.2. It should be noted that although the Crisis Centre opened in its new location on 28 th August, there have been delays in Care Commission 1
Registration that have prevented the overnight stay service commencing. These will be resolved shortly. 3.3. It should also be noted that the changes to the Mental Health Assessment Service and the start of the Intensive Home Treatment Teams will take place by end of October. 3.4. Finally, the review of Community Mental Health Team/Primary Care Liaison Team is being consulted on and will be ready by the end of October. 4. Impact on Health Inequalities 4.1. Individual plans will have impact assessments carried out to ensure that that they reduce health inequalities. 5. Financial Implications 5.1. The financial implications of these proposals are a further full year effect investment of 1.838m in mental health services in Edinburgh. David Small General Manager 2
APPENDIX 1: Item No Report No Update on Edinburgh Joint Implementation Plan to support the Lothian Joint Mental Health and Wellbeing Strategy Joint Board of Governance 4 September 2008 1. Purpose of report 1.1. To advise the Joint Board of Governance of progress made in implementation of community based Edinburgh services to address major priorities identified in the Edinburgh Joint Mental Health Implementation Plan. 2. Implementation Priorities and Investment for 2008-09 2.1. Five key priority areas for development, redesign and investment have been agreed. NHS Lothian will invest a further 1.8m recurringly in these new developments in addition to previous investments. 2.2. 24/7 emergency assessment, home treatment and crisis resolution 2.3. Continuing development of Community Mental Health Teams and Primary Care Liaison Teams and wider community health networks, including the voluntary sector; 2.4. Development of psychological interventions 2.5. Enhancement of accommodation and support services 2.6. Continuing development of rehabilitation services 2.7. The Joint Mental Health Group led by the CHP General Manager is overseeing implementation. 2.8. Recruitment is well underway to the new Mental Health Assessment Service. Based 24/7 at the Royal Edinburgh Hospital and 3
simultaneously delivering a service out of hours at the Royal Infirmary of Edinburgh. This service will also cover East and Midlothian after midnight to 9am the next day. The new service should be fully functioning by October 2008. Interim cover arrangements for the Royal Infirmary have also been put in place. 2.9. Recruitment is also well underway to two Intensive Home Treatment Teams (IHTTs) for Edinburgh, with an operational start date of October 2008. These teams will provide treatment and care in peoples own homes and will be based in the North and South of the city, providing a direct alternative to inpatient care, thus facilitating a further reduction in the requirement for acute psychiatric inpatient beds at the Royal Edinburgh Hospital. 2.10. The Edinburgh Crisis Centre has moved to Smith s Place and officially opened its overnight service on 28 th August. This will provide a new alternative to hospital admission in addition to the previously offered 24/7 telephone support and daytime support in the centre. 2.11. A review of the Community Mental Health Teams has also been completed and the results will be discussed at the next meeting of the Joint Mental Health Group. Implementation of the review will ensure equity of service across the City, joint work with the Mental Health Assessment Service and the Intensive Home Treatment Service, standardization of operational policies and a new emphasis on recovery. 2.12. In September the new matched/stepped care approach for mild to moderate mental health needs in primary care will be launched. This will be signed off at the next meeting of the Joint Mental Health Group. New services will include bibliotherapy, access to stress management support, guided self help and additional psychological therapies. 2.13. The Joint Mental Health Group has begun work on an accommodation and support strategy to complement the changes to rehabilitation services being proposed as part of the Royal Edinburgh Hospital reprovision. This envisages more rehabilitation being provided in the community and an increase in the amount of supported accommodation. 3. Financial Implications 3.1. Additional investments to date in the Edinburgh Joint Implementation Plan amount to 1.3m from the City of Edinburgh Council (not including redesign and reinvestment) and overall 2.52m will be invested in Edinburgh by NHS Lothian, including 1.838 in respect of the new service developments described in outline above, a proportion of which will be funded by disinvestment in hospital based services. 4
4. Recommendations 4.1. It is recommended that the Joint Board of Governance: 4.2. Notes progress made in implementing the Joint Mental Health Plan that will see the allocation of significant additional resources to Edinburgh to enhance and improve key mental health services that help shift the balance of care from hospital to community. Peter Gabbitas Director of Health and Social Care Appendices None Contact/tel David Small, General Manager Telephone: 537 9531 Wards affected All Background Papers Lothian Joint Mental Health and Wellbeing Strategy Delivering for Mental Health Joint Edinburgh Implementation Plan 5