Agenda item

6.1

The Committee received a joint report setting out the Sheffield Mental Health Transformation Programme, which has been jointly developed by Sheffield City Council, NHS Sheffield (CCG) and Sheffield Health and Social Care NHS Foundation Trust.

6.2

Present for this item were Sam Martin, Head of Commissioning – Vulnerable People (Sheffield City Council), Jim Millns, Deputy Director of Mental Health Transformation (Sheffield City Council, NHS Sheffield CCG and Sheffield Health and Social Care NHS Foundation Trust), Melanie Hall, Strategic Commissioner Mental Health (Sheffield City Council), Heather Burns, Head of Commissioning, Mental Health, Learning Disabilities and Dementia Commissioning Portfolio (NHS Sheffield CCG), Heidi Taylor, Clinical Effectiveness Pharmacist (NHS Sheffield CCG), Dr Abhijeeth Shetty, Consultant Psychiatrist (Sheffield Health and Social Care NHS Foundation Trust), Dr Steve Thomas, Clinical Director for Mental Health, Learning Disability and Dementia (Sheffield Clinical Commissioning Group) and Andrew Wheawall, Head of Service for Future Options (Sheffield City Council).

6.3

Jim Millns introduced the report and stated that the Programme had been jointly developed and is being delivered by the City Council, NHS Sheffield CCG and Sheffield Health and Social Care NHS Foundation Trust and is halfway through a four year programme.  He said that the Scrutiny Committee had received a report in January 2018 which outlined the programme and its individual component projects and the purpose of this report was to give more detail on some of the impacts and outcomes which have been delivered by the programme to date.  With regard to delivering a better service to those with mental health problems, areas had been identified which needed improvement and by working in partnership it was felt that this would achieve better results.  He added that prevention was an important element of the overall programme and if the principles relating to health and social wellbeing, prevention, promotion and early intervention were adopted, it would improve the outcomes for service users.

6.4

Members made various comments and asked a number of questions, to which  responses were provided as follows:-

·                     As data shows that Sheffield was higher than the national average for prescribing antidepressant medication, part of this project was to explore potential and possible options to reduce prescribing.  It was felt that ongoing and additional investment in IAPT (Improving Access to Psychological Therapies) and providing education and training amongst GP practices to offer access to alternatives, would have an impact on prescribing patterns, thereby with greater access and reduced waiting times to psychological therapy, it was felt that the use of antidepressants might reduce. It was acknowledged that whilst there was an increase in IAPT services, it may not always be adequate or sufficient to meet the ever changing demands, however no-one should be rejected without access to care. CCG representatives encouraged Councillors to share with them any cases they have come across where individuals have had difficulty in accessing IAPT services.

·                     It was important to note that, on occasion, it was absolutely necessary for both medication and psychological interventions to be prescribed.  Sometimes, antidepressants are prescribed for treating other conditions e.g. anxiety, migraine or premenstrual syndrome.

·                     Since the onset of austerity following the financial crash in 2007, there have been ever-increasing mental health illnesses and to date there was still an unmet need in addressing those illnesses.

·                     The Mental Health Strategy aims to raise awareness and hopes that it resonates to where it is needed the most.  Housing + have been offered specialist training to officers to help them deal with mental health in the more deprived areas of the city and an experienced  Mental Health Social Worker forms part of the Anti-Social Behaviour Team to identify problems there. There is also a mental health professional seconded from Sheffield Health and Social Care (SHSC) to the Sheffield City Council’s (SCC) Housing and Medical Priority Team.  Jim Millns said that he would circulate a link to “”The Sheffield Mental Health Guide” to Members who might find it useful when they are working in their local areas.  The website is aimed at anyone who is struggling in Sheffield, whether they’ve been diagnosed by a clinician or are just having a bad day. The website is available 24/7, and offers a comprehensive guide to mental health services, support and activities in the city. 

·                     With regard to children and young people, there is an overarching ambition to create a “one stop shop” approach towards mental health, so that parents and children can be treated by a single team of professionals.  Included within the mental health strategy timetable is a plan to work alongside the Cabinet Member for Children and Families and the Cabinet Member for Health and Social Care to shape this strategy.

·                     There is a rolling programme to train all new nurses and social workers so that they are more aware of mental health illnesses and able to signpost those in need towards the crisis care they require. There are adult mental health professionals seconded from SHSC to the SCC MAST services.

·                     GPs are fully aware of the professional responsibilities around mental ill-health, and over the last three years there has been positive training support for GPs to provide alternatives in the treatment of mental ill-health, through number of protected learning events ran by the CCG for primary care.

·                     Sheffield has secured additional funding from NHS England to support extending its perinatal mental health service across South Yorkshire, which will provide a more effective service for mums-to-be and partners/fathers who experience mental health problems, to enable them to have a more positive pregnancy and birth experience and make for a better start in life for their babies, as it has been discovered that the family dynamic during pregnancy can have a direct impact on a child’s mental health and wellbeing.  CCG representatives welcomed discussion with Councillors if they were aware of specific cases where they had concerns.

·                     Part of the Transformation Programme was looking at packages that were on offer and identifying what care, although on offer, was not being delivered.

·                     Collaborative working was required between all health professionals, as it was not just the role of GPs, but also the Primary Care Trust, to be able to direct patients to the correct pathway.

·                     The Service Improvement Forum invites anyone to attend and talk about shaping and supporting commissioning functions to procure and influence mental health services.  It was hoped to shape new services based on listening to what people want, involving service users, experts by experience and carers.  The Transformation Programme has an increasingly strong focus on genuine co-production.

·                     With regard to Crisis Care, it was found that the self-referral system has revealed unmet need, and was not set up to meet this increased level of demand. The IT and telephony infrastructure was challenged and this was being improved by the Health and Social Care NHS Foundation Trust. The attendance of people at A&E and in Sheffield Teaching Hospitals (STH) has a mental health offer from the psychiatric liaison service. The service sees people and offers training support to STH staff who are treating physical health needs and their mental health requires support at the same time.

·                     When a patient has been admitted into hospital, part of the discharge plan was to send a letter to their GP, within 24 hours if the case was urgent or within seven days if not. All patients are seen at least within seven days post discharge by a mental health professional.

6.5

RESOLVED: That the Committee:-

(a)       thanks Sam Martin, Jim Millns, Melanie Hall, Heather Burns, Heidi Taylor, Dr Abhijeeth Shetty, Dr Steve Thomas and Andrew Wheawall for their contribution to the meeting;

(b)       welcomes the approach of greater integration and the focus on prevention;

(c)        is concerned to hear examples from Councillors of cases where individuals are falling through gaps in the system, and is keen to see that further work is done to understand how this happens and prevent it happening in future;

(d)       requests that the Mental Health Guide is circulated to Councillors, and that efforts are made to spread this information to private landlords;

(e)       asks that the focus is on outcomes rather than outputs when measuring progress and performance of the Mental Health Transformation Programme – considering what we are trying to achieve, what difference this is making to people’s lives and how we know it is working; and

(f)        notes that the Mental Health Strategy will come back before the Committee at an appropriate time.