JOINT COMMISSIONING PARTNERSHIP BOARD

THURSDAY 3MAY 2007 AT 10 A.M.

QUARTERLY MENTAL HEALTH SERVICES FOR OLDER PEOPLE (MHSOP)

SUMMARY PERFORMANCE REPORT

Author: Steve Malusky, Interim Planning and Commissioning Manager, Mental Health Services for Older People

Tel: 01707 280641

  1. Purpose of report

To provide the Joint Commissioning Partnership Board (JCPB) with an update on the performance of the Service Level Agreements (SLAs) with providers of Mental Health Services for Older People and to brief the JCPB on current developments and issues.

  1. Performance Report on Providers

2.1Hertfordshire Partnership Trust

MHSOP High level Performance Indicators

Performance Indicator / Q2 / Q3 / Target
Older People aged 65+ admitted on a permanent basis in year to residential nursing care. / 83.6 / 80.7 / 86.0
Households receiving intensive home care per 1000 population aged 65 and over. / 9.9 / 10.1 / 10.4
Elderly people helped to live at home per 1000 population aged 65 and over. / 50.0 / 48.4 / 59.0
For new clients, % receiving first contact within 48 hours and first assessment completed in 4 weeks from first contact. / 74% / 75% / 85%
For new clients, % receiving provision of all services in a care package within 4 weeks of completion of assessment. / 97% / 96% / 86%

Source: Hertfordshire Partnership Trust Board Papers January 2007

Further work is ongoing on developing the quality of the data recording which seems to be a major issue across many of the indicators.

2.2Budgetary pressures

Within HPT MHSOP services, the main areas for financial concern are medical costs and costs of continuing care placements. These areas are causing the £200,000 projected overspend for MHSOP services at the Trust.

2.3Cambridge and Peterborough Mental Health Trust

For 2007/08, there will be no change in the commissioning intentions for MHSOP. The Joint Commissioning Team (JCT) informed the Trust that they would be examining the viability of continuing the present arrangements or transferring the service to an in county provider. It is likely that this will be considered in light of the intentions of the Trust to gain Foundation Trust status in 2008.

The following table details the 2006/07 Activity against plan for MHSOP services.

Inpatient Bed Days April 1st to December 31st 2006

Service / Contract Activity / Total / Plan to date / Variance / Variance %
Functional acute / 153 / 108 / 115 / -7 / -6.3%
Rehab / 933 / 580 / 703 / -123 / -17.5%

Outpatient Contacts April 1st to December 31st 2006

Service / Contract Activity / Total / Plan to date / Variance / Variance %
Contacts / 101 / 67 / 76 / -9 / -12%

Overall the 2006/07 contract is underperforming slightly as at Quarter 3, the contracted activity was significantly reduced in 2006/07 and for 2007/08 there is potential to reduce the contracted activity further.

2.4North Essex Mental Health Trust

Since the last report to the JCPB significant headway has been made regarding the repatriation of services from North Essex Mental Health Trust to Hertfordshire Partnership Trust. Formal notice has been served on North Essex Mental Health Trust (MHT). The repatriation of Hertfordshire residents from the Kitwood Unit at Herts and Essex Hospital and patients using other MHSOP services provided by North Essex MHT is due to be completed on 1st June. Hertfordshire residents accessing the Brian Roycroft Unit which is the Mental Health ward within Sydenham House in Harlow will remain in situ, however the notice period on these patients is 30 days. North Essex have informed HPT that these beds may be required by them in the future whilst they undergo their own service remodelling.

  • The capital work at Seward Lodge is progressing well and is scheduled to be completed on time.
  • Human Resources – Staff have been informed of the transfer arrangements, a series of meetings and interviews between all affected parties are being drawn up. Transfer of Under-takings, Protection of Earnings (TUPE) arrangements are causing concern given the distance and scarcity of public transportation between Bishop’s Stortford and Hertford.
  • A communications plan is being put together to ensure all stakeholders including service users and carers are informed and engaged in the process. Local concern has been expressed through the local media.
  • Operational Issues dealing with the change in referral protocols, service models, transport etc have yet to be fully completed and are being addressed through a project group set up to ensure a smooth handover.
  • North Essex MHT has given notice to repatriate Essex patients from the Kitwood Unit within Herts and EssexHospital. This will mean the future loss of an annual rental income to East and North Herts PCT in the region of £600,000. The PCT will either have to seek a new tenant or find an alternative use for the space.

2.5Barnet, Enfield and Haringey Mental Health Trust

For 2006/07 Activity Data has only just been received and yet remains to be validated. Initial results show that the contract is underperforming against planned levels but this needs to be confirmed. Work is in progress to confirm the planned levels and activity with the Trust.

Inpatient Bed Days ~ April to December 2006

Service Type / Currency / 2006 /07 Plan / Total Q3 Apr - Dec / Year End Forecast / Projected Variance
Acute / Admissions / 38 / 16 / 21 / -16.7
Discharges / 27 / 19 / 25 / -1.7
Finished Consultant Episodes (FCEs) / 31 / 20 / 27 / -4.3
Occupied Bed Days (OBDs) / 3,270 / 2,133 / 2,844 / -426.0
Continuing Care / Admissions / 16 / 12 / 16 / 0.0
Discharges / 19 / 9 / 12 / -7.0
FCEs / 24 / 12 / 16 / -8.0
OBDs / 8,532 / 4,947 / 6,596 / -1936.0

Progress has been made on agreeing the overall timescale for the repatriation of Hertfordshire residents from Chase Farm. Agreement has been reached on a phased withdrawal as set out below, to be completed by 1st April 2008.

  • Transfer the acute assessment and treatment inpatient mental health services toSeward Lodge in Hertford from 1st October 2007.
  • Transfer the day hospital and outpatient clinics to Seward Lodge or other local facilitiesin Waltham Cross or Cheshunt, from 1st October 2007.
  • Transfer the continuing care provision to alternative placements in Hertfordshire by April 2008.

A communications plan is being drawn up across the organisations to ensure a smooth transfer. The Interim Planning and Commissioning Manager will be chairing the project team and putting together the project plan.

2.6Reprovision of Services from Pembroke - Watford

The programme for the reprovison of inpatient services has been established and is well advanced. There remains the issue of Day Services provided on the site. There are currently 20 service users. The PCT is asking the existing contractor Shaw Homes to extend the provision of Day Services from July for 6 months. This will give the Health and Care community breathing space to re-design the service model and examine a range of options with a view to having an integrated dementia centre based in Watford. There are currently 20 Day Service users

3.Conclusions/Recommendations

The Board is asked to note the report.

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Item 4d - Mental Health Services for Older People