Item 4a Appendix 3Investment Proposals 2008

Working Age Mental Health (WAMH)

WAMH Recommended Initial Investments

Item / Provider / Purpose / Detail / Likely Spend 08/09 / Total Spend / To When / Commissioner Comment / Progress Report to
1st Sept 2008
Early Intervention Service / HPFT / To allow the service capacity to reach the 450 caseload requirement of the DH / £886,000 / £1,049,000 pa
Ongoing / Essential to meet national targets / Funding is being released in line with caseload to meet the target of 450 by July 2009. HPFT are currently behind target and developing an action plan to recover.
Community Development Workers / (Various Providers) / To support engagement with BME communities and to contribute to fulfilling the DH target of 10 CDWs within Hertfordshire / £305,000
(£331,000) / £331,000 pa
Ongoing / Essential to meet national targets
Includes the reconfiguration of roles within Watford Asian Community Centre and the Hertfordshire County Council Traveller Unit. / 281k has already been allocated to cover cost of CDW services across county currently in place. 30k has been set aside to fund the CDW within the Gypsy Service. Some slippage identified and awaiting final figures
Counselling / TOTAL / £575,865 / To develop a range of counselling and therapy services so as to provide a comprehensive county wide service / All counselling agreed with Local PBC groups to reduce existing long waiting lists in some areas and to deliver counselling in areas where there is no current service.
To develop primary care counselling in South East and East Herts. / £400,000 / £522,733 pa / There are currently not sufficient services available and this will also be needed to enable further psychological therapies next year
Fear Fighter (computerised therapy) / £42,765 / £61,639 yr 1
£123,278 yr 2
£184,918 yr 3
=£369,835 / Full year cost in 08/09. Figure increases as more of the population gain access. Costs based on 3 year incremental coverage package. / For implementation Dec’08/Jan’09 to cover Hertfordshire
Beating the Blues (computerised therapy) / £90,000 p/a from 09/10 / Most current licenses expire March 09 / 2 Licences expire 30/09/08 in Letchworth needing 6mths extension at £2,400pending negotiation
Voluntary Sector projects to develop counselling services / £133,100 / Agreed for 3 years £133,100 p/a / PBC agreedSt Albans Bereavement Network 15k, Stevenage/Nth Herts Women’s Resource Centre 20k, Mind in Mid Herts £63,400, Cruse £5k / £30K yet to be allocated awaiting proposal AB following up Likely to be spent this year.
Improving Access to Psychological Therapies / (JCT) / Supporting implementation of Primary Care Mental Health Development Programme across West Herts and East & Nth Herts / £100,000 / £150,000 (2 years) / Essential for programme and project management and data collection for the IAPT expansion programme and developing Practice Based Joint Commissioning. / Primary Care Mental Health Development Programme Manager (£55k) started 18/08/08. Asst Research Psychologist and Data Entry Clerk (£45k) also in place 22/09/08
Innovation Fund / (Various Providers) / To support a range of pilots which will trial innovative services that might provide improved outcomes for service users andpromote recovery. / £547,900 / £500,000 in 08/09 £300,000 in 09/10 (approx) / Funding in second year will support projects which have achieved the agreed outcomes and have shown best value.This fund will be used to allow third sector and other providers to explore possible new approaches. / Full £500,000 has been allocated and will fund 15 new projects. £45,000 additional funding contribution from Older People Budget for some project focus to include older people. £2,900 to be found from identified slippage.
A&E Liaison (HPFT) / Investment to replicate service currently operating at the Lister and the QEII in the West of the County. Extra funding will allow for 3.5 band 7 nurses and 1 band 8a team leader. / £146,602 / £146,602 pa / This proposal incorporates services for both Watford and Hemel Hempstead. The monies will initially provide service for one year there will be a requirement for ongoing funding but it is recommended that this is dependent on usage data and requirement for the Hemel Service. / Recruitment has commenced with a view to enhancing service from October onwards. It is envisaged that cost this year will be approx 123k. Slippage from this money has been identified to cover the cost of the removal of the CDW post from this service. Future investment to cover this element on a recurring basis will be based on usage data and be subject to next years investment planning.
Accelerated Discharge Programme (HPFT) / PCT allocation to fund medium secure facilities for patients discharged from high secure accommodation / £93,000 / Ongoing / This is part of a national programme where the costs of new placements from high secure must be met / Implemented
Mentally Disordered Offenders Pilot / One third share of project management costs for Watford pilot of national development programme / £10,000 / £10,000 1 year only / The pilot will trial a screening / diversion approach at point of arrest. In partnership with Probation services / Implemented
Enhanced Primary Mental Health Care (HPFT) / Accelerated roll-out of EPMH to Hertsmere and Dacorum. One-off pump priming funding. / Hertsmere
£78,000
Dacorum
£72,000 / £150,000 in year one, £90,000 in year two / Reduced amount in year 2 for these sites due HPFT absorbing the costs of year 1 staffing. / Agreed and Implemented to facilitate release of 1st Wave IAPT funding from SHA in October’08.
Enhanced Primary Mental Health Care (HPFT) / Accelerated roll-out of remainder of programme to provide county wide service (One-off pump priming funding). / SE & E Herts
£126,000
4 Existing IAPT Sites
£158,000 / £284,000 in year one, £387,000 in year two / Essential to enable accelerated rollout of remaining areas of Hertfordshire but commissioners recommend agreement only if a significant acceleration can be demonstrated and achieved. / Significant accelerated rollout on target to facilitate release of 2nd Wave IAPT funding from SHA in April’09
Mental Health Promotion (Various) / Implementation of MH promotion strategy / £25,000 / £100,000 pa for 2 years / Although this investment needs to take place, the timing of it should be finalised dependent on the content and against competing priorities / World MH day events funded with further DRE events under negotiation. Likely spend £25,000 for 08/09
Eating Disorders (HPFT) / Service Expansion due to increased number of referrals and rise in the number of inpatient activity / £100,000 / £400,000 to 2010. / A higher amount may be needed ongoing but recommendation is for 2 year initial funding recommended to test viability and impact / Awaiting final negotiation with HPFT in October’08 to fully update progress.
Mental Health Act Implementation (HPFT / ACS) / To support the implementation of the new Mental Health Act including training cost. / £100,000 / £100,000 1 year only / Level of funding to be finalised once full proposal drawn up. / Non Recurrent expenditure of 70k allocated to pay for training and preparation for the new ACT. Recurrent request to fund 1 WTE mental health act administrator at 32k. Cost this year 16k. Recurring cost to be considered for investment planning 09/10. Potential slippage of 16k. However this is likely to be required for the purchasing of statutory documents i.e. new code of practice. Awaiting CTO mapping from HPFT to look at potential cost implication of the use of this new order. DoH guidance suggest a 5% swing + or – on the gross current MHA related expenditure upon implementation of the Act.
Improving access to therapies on MH acute wards (HPFT) / Funding to support the development of STAR wards within Hertfordshire Acute care to facilitate access to psychological therapies and meaningful activities for inpatients. / £143,333
£250,000 / £500,000 pa for 2 years initially. / Pressures on acute services are recognised to be high and further resource is required. The nature and extent of this resource should be trialled for initial 2 years ahead of ongoing investment / Funding agreed by SCG for HPFT to employ 2wte psychologists to deliver psychological therapies & asst workers to facilitate wider variety of choice and consistent standard of activities available on all the inpatient units. HPFT are also implementing a “Star Wards” approach through existing resources. Starting 01/11/08 at £143,333 this yr with full yr cost £344,000
SUB TOTAL
TOTAL / £3,466,698

WAMH Further Investment Options

Item / Provider / Purpose / Detail / Likely Spend 08/09 / Total Spend / To When / Commissioner Comment / Progress Report to
1st Sept 2008
MH Helpline / (To be decided) / To support out of hours use of on-line Computerised Psychological Therapy, / £50,000 / £50,000 pa Ongoing / Will help deliver better use of computerised approaches and link patients to mainstream services / Does not require funding as current EPMHS will be able to provide necessary cover during normal working hours and appropriate contingency plans made with patients
Crisis Services (HPFT) / Service improvement through expansion of Out of Hour Services / Not yet known / Not yet known / Likely need has been likely for long term planning, / Plan to develop crisis services in 09/10. No planned spend for 08/09. To include in long term investment planning
Employment Support Services (Various) / To pilot the expansion of Way2Work across the County in line with Department Work and Pensions employment programme / £200,000 / £450,000 for 2 years / Way to Work is currently running through Mind in Mind Herts and utilising STaR workers within HPFT. Additional funding would enable the expansion of this programme to other parts of the County.
Rather than provide this suggested one-off funding commissioners recommend this is addressed through long term investment and the innovation fund / Innovation fund funding an employment advisor. To include in long term investment planning
Race Equality / Cultural Competence (Various) / To support ancillary cost of Delivering Race Equality Agenda and cultural competence training / £10,000 / £10,000 pa Ongoing / Although it is essential that this work takes place, it is commissioners current view that providers mainstream resource is already in place for this / Not Agreed
SUB TOTAL / Awaiting further figures / £260,000

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W Lousley17/10/2018