Contact: Carole Bennett, ext: 7153

1. Summary

1.1 At it's meeting on 17 January 2003, the Social Care Policy Review Committee (PRC) received a progress report on the local implementation of the national service framework for mental health services. Members of the Committee took the view that this would be an appropriate matter to raise with the Health Review Committee.

1.2 A copy of the report is attached together with its Appendix 3 - the self-assessment exercise completed by multi-agency Mental Health Local Implementation Teams during September - October 2002. Appendices 1 and 2 of that report comprise detailed national guidance on how to complete the self-assessment documentation and have not been included with today's report. These appendices are published on Hantsnet as part of the report to the Social Care PRC.

1.3 The Health Review Committee is asked to consider whether it wishes to consider any issues raised in the report for scrutiny and review.

2. The National Service Framework for Mental Health

2.1 Mental health services are a priority area of the NHS Plan and are subject to a National Service Framework for the delivery of a range of service improvements.

2.2 National service frameworks develop in greater detail the policy intentions contained in the NHS Plan. They include standards and service models based on evidence and best practice, targets for service improvement, implementation arrangements and timescales, as well as describing the arrangements by which local progress will be monitored and reviewed. The frameworks aim to make the NHS and Social Services more accountable to the general public and the Government for the availability and quality of local services

2.3 The NSF guidance advises local health and social care communities to prioritise investment and reinvestment in the whole health system. It goes on to state that in many areas the first priority will be to continue to address gaps in current services for people with severe and enduring mental illness - 24 hour staffed accommodation, assertive outreach, home treatment or secure beds for example. This is to address issues of equity, access and safety, including public safety. In areas where specialist mental health services are able to meet local needs for severe mental illness, the most cost-effective focus should be on people with common mental health problems.

2.4 The local arrangements for monitoring the implementation of the mental health NSF are set out in the attached report. In summary, there are four key elements:- self-assessment, themed reviews, a review of the `map' of local services and financial mapping. The local Health Authority and Social Services Inspectorate have validated the assessment.

3. Key Messages from the Monitoring Exercise

3.1 The review of progress in implementing the NSF has identified:

(i) a comprehensive care programme approach is in place across Hampshire and the Isle of Wight

(ii) all localities are undertaking health promotion activity

(iii) there is significant investment in secure services which are forecast to achieve local targets

(iv) the effectiveness of Court diversion schemes, where available

3.2 The monitoring exercise also indicates the need for further investment in services in order to achieve local targets and meet national requirements. Areas of concern are broadly reported as being the need to develop preventative and early intervention services such as assertive outreach, crisis resolution, more court diversion schemes and advocacy. Many of these services fall to Social Services to provide. Funding for the implementation of the NSF is allocated to Primary Care Trusts who must balance priorities for mental health services with other NHS plan priorities. Nevertheless there is a concern that social care mental health services are not a priority for funding. The Executive Member for Social Care and officers of the Social Services department are continuing to work closely with the PCTs to influence and inform local decision-making concerning NHS Plan investment in Hampshire.

4. Conclusion

4.1 The report provides a helpful overview of the priorities for mental health services and local implementation. It also serves to highlight the competing priorities for funding and the difficult local decisions that need to be made. There is concern at the apparent lack of priority given to social care funding given its important role in preventive and early intervention services that are a cornerstone of the NSF.

4.2 The role of this Committee is to review and scrutinise NHS services and in considering the issues raised in the attached the report, it will need to consider what `added value' it can bring to the existing review process, findings and action being taken.

Recommendation

That the Committee:

1. Thank the Social Care Policy Review Committee for the referral of the report.

2. Commend the review process and the achievements to date, also the openness and transparency of the findings as reported to the Social Care PRC.

3. Recognise and support the work of Social Services to work with PCTs to address the complex issue of competing priorities for resources, requesting the department keep the Health Review Committee informed of progress.

4. Consider including an aspect of mental health services in the Health Reviews Committees programme of reviews as at future stage.

Section 100 D - Local Government Act 1972 - Background Documents

The following documents disclose facts or matters on which this report, or an important part of it, is based and has been relied upon to a material extent in the preparation of this report.

NB the list excludes:

Published works

Documents which disclose exempt or confidential information as defined in the Act

NONE