Agenda item

The previous iteration of health scrutiny  - the ‘Health, Adult Social Care, Communities & Citizenship Scrutiny Sub-Committee’ carried out two reviews : ‘Access to Health Services in Southwark’ and 'Prevalence of Psychosis and Access to Mental Health Services for the BME Community in Southwark' in the previous administrative year, 2013/14.

This session is for stakeholders to set out how they intend to respond to the reviews recommendations.

6.1  The chair welcomed Gwen Kennedy, Director of Quality & Safety, Southwark Clinical Commissioning Group (CCG); Sally Lingard, Kings College Hospital Foundation Trust (KCH); Zoe Reed, Director of Organisation & Community, SLaM; Eleanor Bateman, Service Director SLaM, James Hill, Head of Nursing, Emergency & Acute Medicine Guy’s & St Thomas’ (GST) and Vanessa Pugh, Interim Head of Older peoples Services, Southwark Council Children’s & Adult Services.

6.2  The chair invited the CCG, Social Care and all the hospital trusts to briefly present the reports circulated. Sally Lingard apologized for the late paper tabled (attached to the minutes). The chair then invited questions.

6.3  A member asked about homeless provision and links with homeless agencies, particularly given the lack of hostel provision and gap in services. The Head of Nursing (GST) agreed that homelessness was a problem and London is the centre of the south east of England. He reported that GST have three workers and are doing very well - sometimes this involves repatriation to people’s place of origin.

6.4  A member referred to the CCG planned move to doctors working in eight local hubs. The CCG director clarified that this has now changed and the emerging plan is looking at a North and South hub which will provide the 8am to 8pm provision. The CCG are looking at local care networks and considering what this would that look like, for example what would be the core offer. To decide this the CCG are utilising local data. The member asked if Guy’s Urgent Care centre is going to stay and the CCG confirmed it would and the Lister will also stay open but will change its remit. A hub location is being looked for in the north of the borough.

6.5  A member raised concerns over bed blocking and asked if there was a need for intermediate beds.  The CCG responded that a new acute director who has been looking at provision of sub-acute beds.

6.6  SLaM and the CCG were then asked if, in retrospect, the closure of the Maudsley emergency provision was the right decision. SLaM representatives said this is difficult to say - there is now more emphasis on a network approach. Presentations that come to Accident & Emergency at the acute trusts (KCH & GST) are now the right people as they are in crisis, whereas the former centre could act as a magnet and attracted people in lower levels of distress, however more needs to be done to reduce the number of people getting into a state of acute mental distress and presenting as an emergency.

6.7  The CCG was asked about performance at the Lister. The CCG advised that the old walk in system has stopped now, and there is now a different set up. There is careful scrutiny of this service and who is using it, with a virtual double running of the services during the transition. The CCG have put in some management of that organisation. She emphasised that this is a new way of delivery primary care.

6.8  A member asked about equalities and mental health and the SLaM Director said that Lambeth has noted that IAPTs is underused by BME people. There is also an under representation of BME people accessing Talking Therapies, and an over representation in acute services. KCH said they have been better matching the make up of staff and patients. The CCG said that there has been much more outreach, including work with black majority churches.

6.9   A member asked about outreach and education with the Latin American community, particularly given the stigma of mental health within this community and that the council has agreed to actively monitor this community to improve access and equality. The CCG offered to provide an update.

6.10   A member noted the good work done by the Interim Head of Older peoples Services and thanked her for her help with someone with dementia.

6.11  The CCG was asked about the dearth of Alcohol and Drug provision in the north of the borough, particularly in Rotherhithe. The CCG director noted the long history of debating this issue at scrutiny and responded that the drug and alcohol team would say they have good outreach and also that GPs have taken on a role in this. There is good coverage and she reported that the needs assessment said the partnerships changes to provision of services have improved access. She noted that there is a cohort that is challenging. She explained the DAAT board looks at this in detail. The member said that the anecdotal evidence is that people are funding it hard to access treatment in Rotherhithe.

6.12  A member enquired about the yellow man campaign and information on accessing the right services, and asked if it would be repeated. The CCG director said it would. It is a national campaign that the CCG is intending to use again and this encourages the use of pharmacies for lesser issues like coughs. It was noted that the Access to Health Care report emphasised the importance of good communication with the public on the right services to access.

RESOLVED

CCG will provide more information on outreach to the Latin American community to improve awareness of mental health issues and access to services.

GST & KCH will provide details on the number of people without homes that they treat and require assistance, as well as the links the hospitals have with agencies that work with homeless people.