Agenda item

3.1

The Board received the following questions from members of the public who had submitted the questions prior to the meeting. The questioners were unable to attend and Greg Fell, Director of Public Health, outlined their questions:-

(a) Louise Wilcockson

I note that there may be potential plans to enable GPs to “prescribe" home repairs or other types of repairs on prescription. This proposal seems to centre around those in Local Authority housing only? Given that Sheffielders also live in private rented accommodation and/or are home owners - sometimes of properties such as multi-occupied flat estates - with arguable anti-social behaviour that affects matters such as Mental Health - a costly matter to any LA - are there any plans to widen the scope of this proposal? Thus, to further strengthen and join up those at SCC et al who have the power, skills and sensibility to prevent mental health conditions caused by, or exacerbated by, property matters? Health matters could and should include mental health, not just physical health. Nor should they be restricted to those just in LA Housing or private rented housing - but private ownership too. We are all Sheffielders. There is a lot to be done around how the cost of serious mental health illnesses caused or exacerbated by anti-social behaviour around someone’s home. These are - in reality - easy to solve matters - with joined up thought and sensible management - especially if experts with lived experience are asked how. I have been asking about this for around 20 years. Will SCC Housing officers be attending newly formed mental health meetings, in the community, connected to the new mental health transformation in our city and working to solve this problem with the most vulnerable in our city? Putting morals aside this would also make more monetary sense and saving money - through sensible joined up thinking and actions - is surely the most effective and sustainable way forward.

Mr Fell confirmed that the following written response would be sent to Louise Wilcockson:

Sheffield does not have any current plans relating to GPs prescribing home repairs. We are however aware of the government legislation on “Right to Repairs”.

Residents of Sheffield do live in multi-tenure areas including social housing, privately rented and owner-occupied homes. SCC and all other social landlords are responsible for undertaking repairs to the properties that we own. Similarly private landlords are responsible for undertaking repairs in the homes they own.   Tenants are responsible for reporting repairs to their landlords and providing access so work can be done.  The Council are the enforcing authority for disrepair in the private rented sector and carry out inspections and enforcement to ensure that standards are appropriate. The right to repair scheme for social landlords covers repairs that have a value of under £250 and commit the LL to undertake repairs in either 1, 3 or 7 days dependent on what they are and urgency. 

SCC work very closely with other partners to address community safety issues such as anti-social behaviour which do impact on mental health. In serious cases all landlords can take action to evict perpetrators – cases are often complex and both those affected and perpetrators can have support needs that require a multi-agency approach.

It is true that there are a range of social determinants to health which have an impact on the mental and physical health of the population, and a number of workstreams at a neighbourhood and city wide level to address these, such as tackling antisocial behaviour. In addition, there is a new Community and Inclusion Delivery Group which sees to make an impact on health inequalities, and this does include the involvement of the voluntary sector and experts by experience.

SCC Housing are working closely with colleagues in Health and other organisations to see if we can do more to improve and increase our work in this area of activity and join up better.  This is also a priority for the new South Yorkshire Health and Housing Group, chaired by SCC’s Director of Housing, which will feed into wider Health conversations.

Officers are happy to discuss this in more detail with Ms Wilcockson if that would be welcomed.

(b) Mr Teresa Quinsey

I would like to put on the agenda for discussion at the next meeting, the provision of a psychology service for 16-18 year olds in hospitals. This cohort of patients falls outside of CAMHS and IAPT and because of the lack of provision in an adult hospital setting, transition is sometimes held back causing strain on children’s services and negatively impacting on the patient’s wellbeing.

Please could you let me know when and where the next meeting is being held and whether this topic can be discussed.

Mr Fell confirmed that the following written response would be sent to Teresa Qunisey:

Mrs Quinsey’s question covers three linked issues:

1. Psychological support for 16-18 year olds in any inpatient bed, either at Sheffield Teaching Hospitals or Sheffield Childrens’ Hospital;
2. Psychological support for 16-18 year olds in specialised commissioned beds; and
3. Transitionary care management.

In relation to the first, patients in Sheffield Teaching Hospitals are covered by the Mental Health Liaison Team, a multi-disciplinary team providing access to consultant-level psychological support, though this is not a 24-hour service.

Sheffield Children’s has a psychology service (PANDA) which covers activity generated in and from Sheffield Children’s Hospital (acute site). This activity is independent of age but rather specialty based and therefore covers 16-18 year olds who remain under the care of the Children’s Hospital.

CAMHS Inpatients Services has Psychology and therapeutic support based on site that is in line with QNIC standards. These colleagues meet the needs of 16-18 year olds who are either detained or informal patients whilst they remain in hospital and will be part of the wider MDT discussions to support transition back to local and national community services.

Each of our specialised Commissioned inpatient services has psychologists as part of the multi-disciplinary team compliment.  This is inclusive of all pathways of care for children and young people in specialist mental health services (also known as Tier 4 services), including those that are accessing services outside of South Yorkshire due to clinical need or bed availability.  There is a psychological component to the service delivery model which is clearly identified in the nationally prescribed service specifications for Tier 4 beds.

Health Partners have recognised the inappropriateness of 16-18 year old contingent young people that present in Urgent and Emergency Care Departments and are detained under the Mental Health Act having to wait whilst specialised Tier 4 beds are identified.  To mitigate against this, a dedicated bed for this cohort of patients has been commissioned (from January 2022) which has drastically reduced the waiting time for a young person in A&E.  Once the young person arrives at the Assessment Bed, they have access to psychological support as the bed is housed on an existing CAMHS Tier 4 inpatient unit.

In relation to transitionary care, there has been a lot of work, particularly in Sheffield, to manage transitions from Children to Adult services.  This work involves mapping the activities of multiple teams across a number of specialties with the aim of learning from best practice. 

Officers involved in commissioning mental health support in Sheffield will contact Mrs Quinsey to discuss this in more detail if that would be welcomed.