JCPB Item 7 Appendix A
Investing in Your Mental Health Decision Day
1.0
Introduction
Representatives from Primary Care Trusts and the Strategic Health Authority met on
5th December to agree their outcomes from the Investing in Your Mental Health
(IIYMH) public consultation. After presentations from service users, carers and
voluntary organisations, decisions were taken in response to the questions posed in
the consultation document. This paper sets out the Decision Day questions and
health service outcomes. It is now for the local authorities to consider and make a
decision on these outcomes in accordance with their own governance arrangements.
2.0
Questions and health service outcomes
2.1
Do you agree that the principles of recovery, mainstreaming, social
inclusion and mental health promotion should be adopted in the delivery of
mental health services in Bedfordshire & Hertfordshire?
This was agreed unanimously.
By agreeing the principle of mainstreaming, we have agreed our policy to repatriate
people into local services from ‘out of county’ providers.
2.2
Do you agree with the priorities set out in the consultation document?
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Children and young people's services?
Adult services?
Specialist mental health services?
Mother and baby services?
Drug & alcohol services?
Services for older people, including separating services for people with
functional & organic conditions?
Learning disability services (where someone also has a mental health
problem)?
Services for people from black & minority ethnic populations?
These were agreed unanimously.
2.3
Do you agree with establishing new urgent and acute inpatient facilities
for children & young people?
This was agreed unanimously.
2.4
If so, which of the following options would you prefer?
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A new unit on the Harperbury site south of St Albans in Hertfordshire and a
new unit in Bedford?
A single unit somewhere central between the two counties?
JCPB Item 7 Appendix A
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Neither?
As there was no clear outcome, the Chairman put forward another motion to the
effect that the decision on this issue be postponed until it can be addressed at a
further meeting of the decision making bodies to be held in early January. This
proposal was agreed unanimously.
2.5
Which option do you prefer for the location of the new facilities in
Bedfordshire for the services currently provided from the Weller Wing?
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Bedford Health Village?
Twinwoods at Clapham, North of Bedford?
Neither?
The first option was agreed unanimously.
2.6
Which option do you prefer for the number and location of acute adult
inpatient units in Hertfordshire?
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4 Units - Hemel Hempstead, Watford, Hoddesdon and Stevenage?
4 Units - Hemel Hempstead, Hatfield Welwyn, Hoddesdon and Stevenage?
4 Units - Watford, Hatfield Welwyn, Hoddesdon and Stevenage?
3 Units - Hatfield Welwyn, Hemel Hempstead & Stevenage?
None of the above?
The three site option was agreed unanimously.
2.7
Do you think that a new inpatient mother and baby unit (to replace the
existing Thumbswood unit at QEII) should be in:
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Luton?
Stevenage?
Hatfield Welwyn?
None of the above?
Hatfield Welwyn was agreed by a majority.
2.8
Do you agree with establishing a single detoxification unit for
Bedfordshire, Luton & Hertfordshire?
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Separate facility?
Co-located with inpatient facilities?
Not at all?
As there was no clear outcome, the Chairman put forward another motion to the
effect that the decision on this issue be postponed until it can be addressed at a
further meeting of the decision making bodies to be held in early January. This
proposal was agreed unanimously.
2.9
Do you agree with relocating some of our learning disability community
support services (such as those provided in Watford and Ware Road) to the
main adult inpatients units?
JCPB Item 7 Appendix A
The relocation some of the learning disability community support services was
agreed by a majority.
3.0
Next steps
3.1
Reconvened Decision Day meeting
Where there was no clear outcome (i.e. young people’s inpatient facility and
detoxification facility), it was agreed that there would be a reconvened Decision Day.
This reconvened meeting will take place on 16th January 2006 (at the Strategic
Health Authority offices in St Albans).
In advance of the meeting, papers will be circulated setting out the benefits of the
various options as perceived by those voting at the Decision Day.
3.2
Joint Overview & Scrutiny Committee
At the time of writing this paper, it is understood that the Joint Overview & Scrutiny
Committee will continue to hold its meeting scheduled for 20th December 2005. The
Committee will use this meeting to consider and comment on the outcomes reached
at the Decision Day. It will consider the questions to be resolved at the Reconvened
Decision day meeting at its next meeting.
3.3
Hertfordshire Joint Commissioning Partnership Board
The IIYMH Decision Making policy paper recognised that the three local authorities
engaged in the consultation (Luton Borough Council and Bedfordshire and
Hertfordshire County Councils) would need to take the health outcomes through their
own local governance arrangements. Through Section 31 agreements, Hertfordshire
County Council (HCC) and the PCTs have delegated the IIYMH decision making to
the Joint Commissioning Partnership Board (JCPB).
This should enable all organisations to confirm their respective decisions at the next
meeting of the JCPB to be held on 26th January 2006.
3.4
Hertfordshire implementation
Previous discussions on implementing the IIYMH outcomes suggest that in the shortterm the existing planning structures should continue.
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The IIYMH Project Board should continue to provide overall strategic
guidance / commissioning intentions on mental health services until such
times as the new local structures are in place (e.g. July 2006).
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The mental health and learning disability workforce group should
continue to work on Strategic Health Authority-wide workforce
development plans;
The capacity model group should complete its work on adult services
and then proceed to older people’s services;
The communications group should continue to develop anti-stigma
and discrimination campaigns.
JCPB Item 7 Appendix A
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The Joint Commissioning Partnership Board should be responsible for
agreeing local plans. However, they would need to ensure that all mental
health services are included (e.g. for children & adolescents, older people,
adults who have learning disabilities).
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The Joint Commissioning Partnership Board should consider
establishing a formal finance working group to develop and progress
the financial framework for future mental health investments.
The Joint Commissioning Partnership Board should consider
delegating the operational responsibility for implementing the IIYMH
outcomes to its Strategic Co-ordinating Groups.
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The Joint Commissioning Team and Primary Care Trusts should forge
stronger links (through the Primary Care Trust Steering Group) and their
Local Implementation Teams and other networks.
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It is strongly recommended that Primary Care Trusts and Social Services use
the Joint Commissioning Structures to agree a detailed statement of mental
health commissioning intentions (based on the IIYMH outcomes). Whilst it is
recognised that existing (NHS) organisations could not necessarily ‘commit’ a
future county-wide PCT to a particular course of action, it is felt that the
commissioning intentions (and short term action plans) should leave a clear
message about the future direction for local mental health services and the
partnership structures should in the interim drive forward initial
implementation.
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If the financial parameters assumed in the financial planning work are to
change then a review of the timescales and viability of the proposals will be
required.
4.0
Recommendations
The JCPB is asked to consider and approve the following recommendations:
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That the IIYMH outcomes agreed at the IIYMH decision day (5th December)
are approved and adopted for Hertfordshire;
That the two outstanding IIYMH outcomes to be agreed at the reconvened
decision day (16th January) are approved and adopted for Hertfordshire;
That the steps set out above for implementing the IIYMH are agreed and
adopted for Hertfordshire;
That the Hertfordshire mental health and social care system acknowledges
that the timescales and viability of IIYMH are dependent on the level and
stability of financing . If financial assumptions change then for
implementation planning to proceed, there will first need to be a further
review of financial viability.
Steve Knighton
Programme Director
Strategic Health Authority
Mark Jordan
Head of Commissioning
Joint Commissioning Team