Meeting documents
Health Scrutiny Sub-Committee (DCC)
Monday 7 January 2008
Meeting: Health Scrutiny Sub-Committee (County Hall, Durham - Committee Room 2 - 07/01/2008 10:00:00 AM)
Item: A5 Service Direction of Tees Esk and Wear Valleys NHS Trust
TRUST BOARD REPORT
JOINT HEALTH AND OVERVIEW SCRUTINY COMMITTEE FOR DURHAM
DATE OF MEETING 7 JANUARY 2008
REPORT ON SERVICE DIRECTION OF TEES, ESK & WEAR VALLEYS NHS TRUST
| Paper addresses/includes the following areas: |  |
| STRATEGIC DIRECTION “Playing our part in creating a complete system of care based on the needs of individuals” “Providing high quality specialist services in partnership with other agencies” “Developing an engaged, modern, confident and skilled workforce” “Attracting, investing and managing resources to make the biggest difference” Equality and Diversity STANDARDS FOR BETTER HEALTH Safety Clinical and Cost Effectiveness Governance Patient Focus Accessible and Responsive Care Care Environment & Amenities Public Health Clinical Negligence Scheme for Trusts (CNST) Auditors Local Evaluation (ALE) | |
1.1 To provide a briefing to the Joint Health of the Scrutiny Committee for Durham on the Tees, Esk and Wear Valleys strategic direction IBP and service directory.
2. BACKGROUND
2.1 The Tees, Esk and Wear Valleys NHS Trust formed in April 2006, provides Mental Health, Learners Disability and Substance Misuse Services for the 1.4 million people living in County Durham, Tees Valley and North East Yorkshire. The Trust also provides a range of specialist services to the other parts of Northern England.
2.2 The Trust employs over 5,000 staff with an annual budget of over £200 million pounds a year.
3. KEY ISSUES
3.1 As part of the ongoing development of the Trust, and in preparation of the Foundation Trust status, the Trust has undertaken the development of a number of service strategies in line with the overall Trust strategy which have been consolidated into the Integrated Business Plan covering the next 5 years.
3.2 Service strategies have considered the new environment, in which the Trust operates including understanding commissioner’s intention, NICE guidelines, performance management requirements, external environment and the Trust financial framework.
3.3 The Service strategies cover Adult Mental Health, older people, learning disabilities and forensic services children and sub misuse.
3.4 Adult Mental Health Services
The principles underpinning the Adult Mental Health Service strategy include developing new ways of working (a national initiative to make best use of all professions delivering care, including consultant psychiatrists) the integration and co-ordination of services (recognising the changes brought about by the new Mental Health Act and new National Health Policy on care co-ordination), the need to streamline a number of developments which have taken place over the past years (crisis services, assertive out reach services, early intervention services) and make these services operate along care pathways that are responsive to individual patient needs.
The key areas that will be considered with Commissioners and Local Authorities, in implementing the adult mental health strategy will be as follows:
· Primary careThe key areas that will be considered with Commissioners and Local Authorities, in implementing the adult mental health strategy will be as follows:
· Community teams
· Inpatient services
· Day services
· Rehabilitation and continuing care services
All of the above services will be developed and in some places there will be “a step change” on how the services function and are delivered.
3.5 Services for Older People
The same principles as outlined for Mental Health Services for Adults will apply to Mental Health Services for Older People. Particular changes will be focussed in the following areas:
· Bed Base Provision - there is a mix of service provision across the Trust in regard to, continuing care and challenging behaviour. Therefore, the Trust will, in partnership with Commissioners consider the reconfiguration of beds around challenging behaviour and assessment treatment with a greater emphasis on management and treatment of people with difficult and complex conditions.
· Day Services - as with inpatient beds there is a need to refocus the purpose of day services, again in partnership with Commissioners and Local Authorities, to ensure these resources are being used in a way that is most effective for those with greatest needs.
· Community Teams - The Trust recognises there is an imbalance of resources presently devoted to community services for older people. Therefore, the Trust, again in partnership with Commissioners and Local Authorities, will look to increase community provision for older people as is the case of adults across a 7 day 24 hour period to ensure as much care as possible will be provided in people’s homes. 3.6 Children Services - Mental Health and Learning Disability
The Trust will work with colleagues in local authorities and with Commissioners for developing children services particularly around:
· Eating disorders· Specialist child LD community forensic services
· Development of community based Tier 4 Assessment services for children with LD with severe challenging behaviour / complex needs
· Development of specialist child LD community forensic services
3.7 Learning Disabilities Services
The Learning Disability Service strategy has three broad aims as follows:
· The Trust will be a source of high quality expertise for people with learning disabilities and complex problems which facilitate individuals into a normal life style.
· To work in partnership with people with learning disabilities and their carers and other key stakeholders to deliver personal centred services based on individual needs.
· To focus on governance and performance to demonstrate constant high quality outcomes from people using services.
To deliver these aims the Trust will reduce reliance on bricks and mortar services particularly around long term residential function and day services. The service will place a greater emphasis on specialist community based interventions, using clearer and persistent pathways along with a robust and comprehensive care coordination system.
Lanchester Road Hospital this will be a purpose built facility for assessment and treatment services for LD.
The Trust will continue with developing a model of specialist provision based on multi disciplinary and multi agency working to develop models of care for individuals needing forensic learning disability services. The service models will include the following elements:
· Specialist community teams
· Low and medium secure services
· Locally based rehabilitation services
· Specialist occupation related day services
· Expansion of beds as part of ADVANCE will allow more local provision
3.9 Forensic Mental Health Services
The service model for Mental Health Forensic Services will include the following components:
· Specialist multi-disciplinary agency forensic mental health teams· Specialist input to prisons and the criminal justice systems
· Lower and medium secure services
· Expansion of beds as part of ADVANCE will allow more local provision
· Additional provision for women and older people
4. FINANCIAL, LEGAL AND EQUALITY AND DIVERSITY IMPLICATIONS
4.1 A number of the service development, are already subject to agreed business plans with the development of new in patient facilities at St Lukes (Roseberry Park) which is part of the Advance business case and Lanchester Road.
4.2 Other service development will be subject to local consultation and engagement with a wide range of stakeholders through the local authorities and PCTs and in some cases funding agreed with commissioners.
5. CONCLUSION(S) BASED ON THE KEY ISSUES AND FINANCIAL, LEGAL AND EQUALITY AND DIVERSITY IMPLICATIONS
5.1 The Trust has laid out significant service delivery plan through its Trust Strategies and Service Strategies for the next 5 years.
5.2 Some of the changes will need to be consulted on with our staff and also with the wider communities. Plans for such consultations will be agreed with our local commissioners as required.
6. RECOMMENDATIONS
6.1 The Health Overview and Scrutiny Committee for Durham to note the key developments for the Tees, Esk and Wear Valley Trust for the next 5 years.
Do we want to ask them to agree to further discussion as detail is worked on?
Name of Author
Harry Cronin
Job Title of Author
Director of Nursing, Psychiatry and AHP
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