Minutes of the VCS Forum for Mental Health
20th May 2014 at the Priory Street Centre 2 – 4pm
John Burgess, Chair
Lynne James, Mainstay
June Tranmer, The Healing Clinic
Catherine McGovern, City of York Council
Alyson Scott, York Mind
Vanessa Langford, Magnetic Arts
John Brown, Healthwatch York
Lizzy Ferguson, The Retreat
Sharron Smith, York Carers Centre
Fiona Hick, York Carers Centre
Julie Kay, York Housing Association
Andy Ward, Community Links
Alan Dunnett, 1-2-1 Counselling
John Yates, YOPA
Catherine Surtees, CYC/York CVS
Carole Money, York CVS (Minutes)
Jill Copeland, LYPFT
Dr Mark Hayes, VOYCCG
Nick Rowe, Converge, York St John University
Jon Woolmore, Community Links
Rita Sanderson, YREN
Mary Hodgson, Castlegate
Shirley Gennery, Castlegate
Cllr Helen Douglas, (CYC)
Nigel Ayre, York Mind
York Womens Counselling
Cllr Tina Funnell (CYC)
Jeremy Jones, Arc Light
David Smith,The Retreat
Rachel Fullerton, IDAS
Louisa Tittler, The Healing Clinic
1. Welcome The Chair welcomed everyone to the meeting with a special welcome for new attendees and guests. Items on the agenda were taken out of order as Jill Copeland had to leave early: Item 2 followed Item 6 and there was an additional item but for easy reference they are shown in number order.
2. Minutes of meeting held 18th March 2014
Page 2 – Waiting lists for counselling update: there was concern about this due to some substantial increases in waiting times:
York Mind – Gone from 10 weeks to 6 months.
1-2-1 Counselling – 6 to 8 weeks.
Mainstay – now offers counselling.
Julie (YHA) asked if anyone knew what the CBT waiting lists were like? They were improving but they remained well below target.
Page 3 – Mental Health counts for 23% not 28% of the disease burden.
The Retreat – Recovery College. Nick - Converge are ‘potential’ partners.
Page 4 – Item 6 has been a partially satisfactory outcome, no significant change to the Mental Health and LD Partnership Board – but the OP& LTC was to be merged with the Collaborative Transformation Board.
Page 6 – Supported Volunteering (this was covered under agenda item 7)
3. Planned reprovision of Bootham Park Hospital – Jill Copeland, Chief Operating Officer and Deputy Chief Executive from LYPFT.
Jill gave context to the reasons for the reprovision of the inpatient wards at Bootham Park (BP) and Lime Trees (service for children and young people). LYPFT have been involved in Mental Health Services in York for 2 years. They don’t own either premises; they are owned by NHS Properties Services Ltd. Feedback from a CQC inspection deemed both premises not fit for purpose and raised ‘moderate concerns’.
Neither Lime Trees nor Bootham Park are fit for modern mental health care provision, and neither do they meet the Disabilty Discrimination Act (DDA) requirements.
The long term plan is to have a new purpose built hospital for Mental Health in York but LYPFT have had to look for interim solutions.
The existing landlords have two existing properties that can be used as a short-term measure.
Mill Lodge (Huntington) will replace Lime Trees. It should be available in approximately 6 months. It will provide space for therapy, more beds, and outside space providing an environment that will give scope to work with very disturbed young people. This will allow more children and young people to be cared for near their parents in York rather than having to be placed out of area. It might become a permanent solution.
The move from Bootham Park is more complex and will take longer. CherryTree House (east of the city) is a temporary solution for the Elderly Assessment Unit (Ward 6) and will be available within about 6 months. Peppermill Court (near Bootham) will house inpatients for men and women (existing Wards 1 and 2 at BP), Crisis Assessment Service and the Place of Safety but this could take up to 18 months to complete, as first LYPFT need to provide suitable alternative accommodation for the existing service users at Peppermill Court (elderly men with dementia).
. Options for the Peppermill Court service users are the Retreat or existing community units for the elderly (Meadowfields in York and Worsley Court in Selby).
Jill stressed this is an interim proposal, it isn’t perfect; we should continue to say it isn’t perfect so that the long term plan for a new build will be realised as soon as possible.
For further information: go to LYPFT website and see paper for agenda item 8 of the Public Board Meeting held on 24 April 2014.
JY – What is happening to psychological therapy services?
JC: People with more complex needs are being supported through Community Mental Health Teams and St Andrew’s. LYPFT are talking to Vale of York CCG about extra resources for Improving Access to Psychological Therapy (IAPT) for those with mild to moderate needs as this service is currently underfunded against the national target. IAPT workers are highly trained, requiring specialised training. Locally this is provided through Sheffield University.
LJ: What is the proposed timetable for the changes?
Mill Lodge (Children & Young People) - 6 months
Cherry Tree House (Elderly Assessment Unit) – 6 Months
Peppermill Court – (Inpatients, Crisis Assessment Service, Place of Safety) – 18 months
JB – Who is involved in the decision making process and ensuring it happens?
JC: LYPFT Board, CCG Board and NHS Property Services. It has to be commissioner led.
JB: What about consultation?
JC: Scrutiny led by CCG (and NHS England specialised commissioners for Lime Trees). LYPFT are consulting with service users. It’s engagement rather than consultation because this needs to happen quickly. Consultation will take place to inform what the new hospital will be like through the CCG’s processes for consulting on the longer-term strategy for mental health.
LJ: Will NHS Property Services own the new building?
JC: Yes, if funding is approved from NHS England. NHS PS will put a bid together with NHS England. Funding is approved nationally. Hugh Bayley MP is on board; he has written to the Secretary of State. Julian Sturdy MP has also been approached. It will not be a PFI (Private Finance Initiative) venture as LYPFT will lease the building from NHS Property Services Ltd.
What is the time-frame for new build?
JC: Three to four years. CCG is currently involved in developing a Mental Health strategy for the city. In the next 3 months there will be a wide ranging consultation which will inform what is required for the new build.
Q: How is this to be funded?
JC: NHS Property Services will pay to refurbish the buildings for the interim solution; it will be cheaper than converting existing properties. They are confident money will come for the capital build.
An Acute Liaison Psychiatry Service (ALPS) will be commissioned this year in the A &E department at York Hospital, funding mainly by LYPFT and York Hospitals Trust, with a contribution from the Better Care Fund
Q: Does this make the provision more comparable to the facilities in Leeds?
JC: The CCG has acknowledged the under-investment in York and aims to improve, through the Better Care Fund and improved commissioning. With the new Place of Safety (Section 136 suite), ALPS and a dedicated Personality Disorder Service at St Andrew’s progress is being made.
The Chair thanked Jill for attending the meeting and acknowledged her message that we must campaign as a Forum to keep these issues at the top of the agenda. The ultimate aim must be to provide a modern, purpose built Mental Health facility for the residents of York.
Additional Item to the agenda. Nick Rowe – Converge, York St John University
Nick spoke about Converge, a new initiative which offers courses to people with mental health issues at the university. They are delivered by staff and students using an education recovery college model. A broad range of courses are on offer - all in the Arts Department. 72 people will complete the courses and 36 students are involved in the delivery. 6 have moved to under-graduate level. All students can use the library and have associate membership of the Student Union. The university is fully supportive. The aim is to extend the range of courses into other areas and to accredit the courses to level 3-4. There is a student buddy scheme, a theatre company and a choir.
Q: How can people access the courses?
NR: Mainly self-referral (80%) but they must be using mental health services.
Q: What are the benefits?
The benefit to the university is it meets the need for diverse students. The students are being supported without directly addressing MH through education and social involvement. Converge = convergence of interests.
Q: What is the age range?
NR: 21 – 68 years currently but there is no cut off point.
4. The Recovery College
David Smith sent apologies; Lizzy Ferguson agreed to present this item. Firstly, it is for everybody living in York, not just The Retreat’s patients or people who use mental health services. It will not be delivered solely by The Retreat nor is it solely for Retreat clients. The model came from CMH Recovery College. The Retreat began with a consultation with service users, families and carers across York, through Converge and the VCS to shape the Recovery College in York.
Feedback showed the need for a vocational pathway where stigma is not an issue.
The aim is to provide a multi-site educational recovery programme.
The Retreat met with various partners including Converge and LYPFT and intend to speak to members of this Forum. Lizzy invited questions.
Q: Who is paying for it?
LF: This is still being worked out. The Retreat will set up a bursary fund to help those who find the costs difficult.
Q Where are the sites?
LF: YSJU, The Retreat, Sycamore House already have courses but they must ensure they follow the Recovery Model.
Members at the meeting responded - many run courses with very similar working methods to the recovery college model. There was concern about the lack of consultation before the launch in April.
The general consensus was everyone would like to be included in the discussions from now on.
Q: Is there a prospectus? – There were concerns from the Forum that there might be overlap.
LF: Yes, they are about to develop a curriculum which should be available in September. It is being managed by the new manager Emma Harris.
Q: What is the next stage?
LF: Two stages - one to get to where they are with current partners, and prospective new ones. Secondly there is much development work as there is no blueprint for an independent Recovery College.
Q: This initiative fits well with the HWBB health scrutiny policy and it may be worth mentioning to Cllr Tina Funnell. How would you explain the model to the Press?
LF: It is a set of courses under an education model which means it has less stigma attached.
Q: This is such an important area of work, why did the majority of the Forum members, many potential significant partners, not know anything about it until the last meeting when it was about to be launched?
LF: This initiative came from the needs of service users who are having problems accessing courses at the moment.
John Brown added - community engagement is progressive. He accepts this is in its early stages.
Q: Is there a steering group, and how is it made up?
LF: Yes it is newly formed. People around the table would be welcome to join.
The Chair thanked Lizzy for presenting this item.
5. CCG’s Strategic Plan – Presentation by Dr Mark Hayes from VOYCCG.
He presented the CCG’s 5 year Strategic Plan 2014-2019. It will be signed by all partners including LYPFT, Healthwatch etc and will have 30-40 signatures. It centres on:
Primary Care – It will take the best current GP services forward to move into the future (CCG Spend 2013-14 £49m)
Community Services – these were transferred, not transformed. (CCG Spend 2013-14 £29m)
Mental Health – New proposals for Bootham Park and Lime Trees. (CCG Spend 2013-14 £39m)
Acute Services – Even though this winter wasn’t harsh, services are still on the edge just working within capacity. (CCG Spend 2013-14 £215m)
Social Care – 30% cuts making a substantial contraction in services. CCG will be linked to the Local Authority through Better Care Fund (BCF). This will involve improved links with the Voluntary Sector. BCF transfers 3% of CCG funds into a pooled budget with LA but they are able to transfer more.
Third Sector – CCG recognise the need to include voluntary sector groups in the plan and acknowledged that this hasn’t happened in the past.
Funding – The Hospital absorbs money as it is paid for what it does; if less people were admitted more money would be available to fund community services. A 5% reduction in funding to acute services would provide 9% growth to Mental Health, Community Services and Primary Care.
New Service Model - CCG have spoken to the Retreat about a new MH hospital with a possibility of it being in their grounds. A consultation about what it should look like is already underway and needs to go wider. Forum members are encouraged to respond.
Integrated Care A new Integrated Health & Social Care Model (from a New Zealand model) has been designed putting the patient at the centre of their care. These are
Care Hubs. There will be 1 to 4 Hubs covering the whole of the CCG area. There will be several partners. They will involve groups of GP practices working in partnership with other services. New Out-of-Hours services will be commissioned next year; the aim is to increase practice hours to 12 thereby reducing the current out-of-hours time.
MH Procurement begins October 2015 and it will be part of the Care Hub.
Community Services starts 2016 – Care Hubs need to be in a strong position to bid by next year. The overall aim is to reduce acute services in hospital with more provision in the community and to keep people fitter for longer. The Hubs potentially give patients a service providing: Primary Care, Community Care, Mental Health, Social Care and Multiple outpatient services.
LJ: Will there be VCS representatives in the Care Hubs?
MH: Yes – there would be scope for that. A Hub is a network not an entity and ownership of the overarching body could be a social enterprise.
Q: Geographically it may mean VCS organisations will overlap; how can this work?
MH: GP practices will stay, Hubs are not necessarily about buildings; they could be virtual. There might be just one Hub.
Q: Would just one Hub bring limitations?
MH: Possibly, at the outset it was thought there might be several, healthy competition is good, there is still potential for there to be 3/4.
Catherine – has sent information about the consultation. Here is the link for your response:
Q: CCGs seem to be moving responsibility nearer to the GP through the Hubs. Is this correct?
MH: Yes, it allows a closer link with the patients and smaller units allow them to have a better sense of what’s being spent. Care Hubs could be allocated funds for a patient for a year, an incentive to keep them well.
Q: Where is the decision to access services?
MH: With the patient as much as possible, the ultimate goal would be to have choice.
Q: VCS receive very small amounts to deliver MH services. We are receiving well below the national average; we need more financial support to enable us to do more. What is being done to address this?
MH: Recognises this problem and CCG will be investing what they can in Mental Health. Hopefully this summer’s consultation will help to facilitate this.
CCG is already looking at IAPT services. He will be contacting Mind to see if we can improve IAPT services and would welcome more feedback from others. Next year’s contracts will be for a larger sum of money, LYPFT were short of funds. Investment in Mental Health is a key part of its strategy.
These changes present more opportunities but funding is a barrier. Would the CCG consider the access of funding through a grant process rather than contracts which are often time limited? This would be far more accessible for smaller organisations.
MH: This can be considered.
ACTION: Carole Money will send out Dr Hayes’ presentation with the minutes.
The Chair thanked Mark for attending the meeting and his informative presentation.
6. Information Exchange
Vanessa - Magnetic Arts. Love Arts Festival is underway and will end 30th May. Also has funding for Summer Arts Schools – two 10 week courses begin in June.
Lynne – Mainstay. – The new Short Course for Recovery Programme for 2014 is now available.