Agenda item

The Committee received a joint presentation of A Lowery, Director of Quality Governance and Dr C Lanigan, Associate Director of Strategic Planning and Programmes (for copy see file of minutes).

Members were advised that the draft report would be circulated to Members in the forthcoming days and that he would provide an update to the Committee in 6 months.

Councillor Kay noted that the cohort that the data had been collated from seemed to be inpatients only and the Director of Quality Governance advised that it was primarily inpatient data, with some some community data however the mental health trust was split equally between community funding and inpatients with much of the inspection issues over the previous two to three years being inpatient focused. 

In response to comments from Councillor Kay regarding the CQC inspection of West Lane Hospital which had been subsequently closed and he hoped that lessons had been learned.  The Associate Director of Strategic Planning and Programmes advised that the facility had been reopened at Acklam Road, Middlesbrough and was managed by a different Trust.  After the closure of West Lane, Durham children were admitted to Prudhoe, then Middlesbrough however Acklam Road had taken admissions since Christmas which had reduced travel and he confirmed that although very few children needed inpatient beds, the replacement unit was off to good start.

Ms Gott noted that the figures did not seem to be addressing patients in the community and asked for a breakdown of inpatients and those cared for in the community. 

The Associate Director of Strategic Planning and Programmes confirmed that 90% of patients were cared for in the community however due to a few challenging CQC inspections over recent years, the Trust had focused on making improvements to inpatient areas with a community mental health transformation.  The proposals would ensure that people in the community could access treatment earlier and additional national funding had assisted to improve that area and reduce numbers of inpatients.

Ms Gott had concerns about the closure of Primrose Lodge in Shildon as if they did end up at capacity, patients would be moved back to a hospital environment, however the Associate Director of Strategic Planning and Programmes advised that the changes within the service would allow more community based intervention to avoid admissions and he also highlighted that some of the previous admissions were not for rehabilitation but utilisation of beds with people who required other treatments.

With regards to the closure of Primrose Lodge, the paper which had been circulated included all of the data including that the Trust had had invested significantly in home treatment to enable people to remain at home.  The investment was way above the national average and the Trust was confident that the bed reduction was compensated.  It also confirmed that the premises at Primrose Lodge was not fit for purpose.

The Principal Overview and Scrutiny Officer advised that there had been an internal TEWV FT working group to consider the issues regarding the transition between Children and Adults Mental Health Services and he queried whether any evidence as to whether the project had been progressed and improvements made.

The Associate Director of Strategic Planning and Programmes advised that transition panels, although not perfect had improved the transition which was why there was no data recorded.  The Director of Quality Governance advised that the transition panels included representation from education and the local authority and if any issues could be picked up early to ensure seamless transition.  There had been a number of events to look at partner transition, which had been put on hold due to the pandemic however there were plans to reinvigorate.

Councillor Savory confirmed that there were serious delays in mental health referrals to CAHMS and the time taken for diagnosis and treatment, and school children had been impacted due to the pandemic.  Even the time to get an initial appointment had resulted in a long waiting list.

The Associate Director of Strategic Planning and Programmes advised that due to the pandemic, mental health had declined with children and young people, there had been an increase generally but also a spike in eating disorders.  It was a difficult area for improvement with a shortage of mental health workers before the pandemic, however there were improvements such as the opening of a medical school in Sunderland and despite taking seven years to train doctors, the fact that the government had invested in new teams to support mental health would see an improvement in the long term. 

There was also recruitment and training in the workforce which was not in place across the whole county but every year more people were being trained and eventually it would be at a stage where there was a level in schools offering support at the very early stages of becoming unwell.  The new service would start to make a difference and changes such as the keeping in touch service, which checked in on young people on the telephone to ensure they were not deteriorating assisted to improve the overall service.  Staff levels were insufficient to meet demand and the CQC had commented on the high caseload and many clinicians had too many cases but with difficulties in recruitment and people tempted elsewhere by signing on bonuses.  More recently there had been recruitment through apprenticeships, with the government apprenticeship levy however as fast as people were being recruited, there was another cohort of people reaching retirement age.

The Principal Overview and Scrutiny Officer advised that the Children and Young People’s Overview and Scrutiny Committee had identified the issues of waiting times, capacity and demand in CAMHS and an item would be considered by them in the new year and an invite extended to this Committee.

Councillor Howey was concerned at the number of people that were anxious about leaving the house post pandemic and wondered how to get counsellors back in GP surgeries and in the community.  So many people were training in colleges, and they needed to be utilised.

The Associate Director of Strategic Planning and Programmes confirmed that a number of surgeries were working with voluntary sector organisations to provide counselling services such as Talking Changes but this service was not suitable for everyone and face to face appointments were needed.

The Associate Director of Strategic Planning and Programmes confirmed that CAMHS were receiving additional funding to allow expansion in 2023 and the Council had signed a seven year with the voluntary sector in order to be more flexible and less formal, moving towards the stage where people were given initial help and advice, moving on to the statutory service if that didn’t work.

Resolved

That the content of the report and presentation be noted and member comments be incorporated into the Committee’s response to the TEWVFT’s Draft Quality Account for 2021/22.