minutes

The Minutes of the Meeting held on 19 March 2014 (Minute Nos. 653 - 659) were taken as read, approved and signed by the Chairman as a correct record.

declarations of interest

No interests were declared.

part one - substantive item

mental health provision review

The Chairman welcomed Andrew Scott-Clark (Acting Director of Public Health, KCC), Alan Heyes (Mental Health Matters - Community Engagement Kent), Councillor Ken Pugh (Cabinet Member for Community Safety and Health), Amber Christou (Head of Housing, Swale Borough Council) and Jo Purvis (Health Partnership Officer, SBC) to the meeting.

Councillor Roger Truelove, Lead Member for the review, explained that the Committee were reviewing the provision of community mental health services.

Members then asked the following questions:
What are the challenges facing community mental health care in Swale? Particularly in terms of resources and areas of Swale with significant housing need and high unemployment?

Amber Christou advised that there were capacity and resource issues around servicing mental health in Swale. She spoke about the Health and Wellbeing Board which had been set-up to tackle the multi-layered mental health issues in Kent.

Jo Purvis stated that particular wards in Swale had significantly higher levels of people suffering from mental health issues than other areas of Kent. She stated that SBC were working to ensure mental health was embedded within their Homelessness Strategy and were also developing partnerships with external providers.

Alan Heyes explained that Mental Health Matters (Community Engagement Kent) were a voluntary organisation. He spoke about the Live it Well website which listed mental health resources that could be accessed.

Andrew Scott-Clark of Public Health, KCC), stated that areas of deprivation in Swale were particularly susceptible to mental health issues and were a challenge in terms of support. These areas included Sheerness East and West, Murston and Leysdown. Mr Scott-Clark considered that social care and a holistic approach to patients needs was required. He considered that local commissioning would enable improved mental health care provision than had previously been provided. This would offer an improved response to the needs of patients rather than the previous 'institutionalised' commissioning approach to services by clinical specialism.

Swale Clinical Commissioning Group (CCG) was due to take over the commissioning of mental health services from West Kent CCG. Did it have the capacity to do so?

Is the size of Swale CCG big enough?

Amber Christou stated that hopefully it was and time would tell. The senior management team encompassed Dartford, Gravesham and Swanley as well as Swale.

What was the role and awareness of mental health with General Practitioners' (GP)?

Councillor Pugh reported that he was aware that there was a shortage of psychiatrists and the CCG's were treating the matter as a top priority. The CCG's vision was for community based multi-agency health teams, including mental health to be located around GP surgeries. He stressed the importance of recognising the early stages of mental health problems.

Councillor Pugh advised that they were engaging with the voluntary sector and spoke about 'Swale Your Way' who were based in Sittingbourne and on the Isle of Sheppey. They offered support for people displaying the early signs of mental health problems and also encouraged them to get physically active.

Mr Heyes stated that there were voluntary mental health workers based in some GP surgeries. Mr Heyes stated that voluntary groups often found it difficult to engage with GPs. This meant that people were often being offered medication, when counselling may be a better option.

Does Swale have a particular problem recruiting psychiatrists?

Councillor Ken Pugh advised no more so than other areas of Kent but the problem was getting worse.

What was the link between mental health and deprivation? And how does our housing policy tackle it?

Amber Christou stated that through SBC's allocations policy the homeless with mental health issues were given priority dependent on their circumstances and offered more support by SBC's Housing Options team. She stated that SBC worked closely with the private sector and KCC to ensure vulnerable people were housed appropriately.

Had there been any issues with the move from Primary Care Trusts (PCT) to Clinical Commissioning Groups? How had the CCGs coped with the challenge?

Amber Christou advised that a lot of the staff from the PCT were now part of the CCGs so that had enabled a smoother transition. She added that when some of the current contracts came to an end, the CCGs would come into their own.

Mr Scott-Clark stated that it was a challenge to ensure that monies where allocated where they were most needed as it was for any organisation. The NHS had to split budgets as never before and this was also a real challenge.

Will SBC have a role in the monitoring of providers and contracts?

Amber Christou stated that 'yes', SBC would be involved and that was why the new post of SBC Health Partnership Officer had been created.

Mr Scott-Clark stated that they would expect the CCG to monitor funding and the contract. They would also need to comply with clinical guidance and public and private experience data of the service would need to be provided.

Do Swale and Thanet have higher mental health issues than other areas?

Mr Scott-Clark stated that data from the Mental Health section of the Joint Strategic Needs Assessment carried out showed that Swale had much higher levels of mental health issues than other parts of Kent. He agreed to forward the data to the Committee for information. Although this data was currently being updated.

What voluntary sector provision was there in Swale and were CCGs providing funding for them?

Mr Heyes stated that voluntary sector provision in Swale was comparable to other areas. He spoke about Insight Healthcare a specialist provider of primary care and a 24 hour helpline funded by KCC which enabled people to self-refer.

Councillor Pugh advised that Kent and Medway NHS and Social Care Partnership Trust (KMPT) were operating at the Sheerness Gateway, Trinity Road and Swale Your Way, were based at the Healthy Living Centre in Sheerness and in Sittingbourne.

Amber Christou considered it was not clear enough all that the voluntary sector provided in terms of mental health support and that frontline services needed to be better informed.

Were GPs aware of the voluntary sector provision available? And did Swale promote on their website?

Mr Heyes spoke about the Live it Well website and that GPs should be more aware of the services they provided.

How does the service try to get mental health taken seriously? What methods are employed to overcome stigma?

Councillor Pugh explained that the CCGs were publicising these groups all the time and training with GPs was underway to ensure that mental health issues were taken seriously with psychiatric nurses being based at surgeries. Councillor Pugh considered that the use of voluntary drop-in services within communities would also help to better inform people about mental health illness and remove stigma.

Mr Scott-Clarke stated that Mental Health treatment was a priority of the Kent Health and Wellbeing Strategy . He spoke about KCC's work with young people to help them cope with life pressures.

Amber Christou advised that it was important how SBC embedded mental health within it's policies with particular emphasis around healthy living. She stated that Swale Health and Wellbeing Board would not have a separate sub-group for mental health as Canterbury Health and Wellbeing Board currently do, because we want to ensure that it is grounded within the work of all the Board's sub-groups it was important to ensure that mental health was included in all Council strategies that impacted on residents.

Homelessness can lead to mental health problems so why does SBC not use some of it's reserves to fund a property?

Amber Christou stated that this was a question for the Cabinet Member for Housing to respond to. She stated that more affordable housing was needed and CCGs needed to ensure the necessary pathways were there for people to access housing.

Mr Heyes spoke about 'Crisis Houses' which were a halfway house for short term intervention for people with severe mental health issues.

Do we have a case in Swale to provide a 'Crisis House'?

Mr Heyes stated that Swale did have a need and advised that Medway had recently set-up one for people with personality disorders which was due to be opened shortly and agreed to provide details.

What impact do holiday makers on the Isle of Sheppey have on figures for mental health? How do Gypsy and Travellers fit in as they are part of the local community?

Mr Scott-Clarke stated that CCG funding did take account of temporary residents and caravan parks were not new to Swale and that would have been reflected in GP budgets. Mr Scott-Clarke advised that the gypsy and traveller community were a vulnerable population and often did not access services until illness was at the acute stage.

How are other professionals engaged around physical health?

Mr Heyes stated that physical illness impacted on mental health and it was important to ensure that particularly the long-term sick were supported.

Mr Scott-Clarke stressed the importance of ensuring that the right expertise was provided at the right time

Councillor Pugh stated it was important to ensure that the correct 'wrap-around' professional team were signposted to the right person.

The Chairman stated that mental health problems in young children were increasing and early intervention was critical and ensuring the necessary resilience was in place.

The Chairman thanked Mr Scott-Clark, Mr Heyes, Councillor Ken Pugh, Amber Christou and Jo Purvis for attending the meeting.

other review progress reports

Councillor Roger Truelove gave an update on the Sittingbourne Regeneration Review. Councillor Truelove reported that the review group had been briefed by the Cabinet Member for Regeneration, Director of Regeneration and the Project Manager for Sittingbourne Town Centre Regeneration who had advised that the original proposals had been altered and there was now less money for Phase II of the Project.

cabinet forward plan

The Committee noted the Cabinet Forward Plan.