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APPENDIX 1

Population changes

Social Services Area

1999

18 Yrs

Forecast

19-64 Yrs

2000

18 Yrs

Forecast

19-64 Yrs

2001

18 Yrs

Forecast

19-64 Yrs

2002

18Yrs

Forecast

19-64Yrs

2003

18Yrs

Forecast

19-64Yrs

2004

18Yrs

Forecast

19-64Yrs

Total %

Increase

Alton/Aldershot

3,720

151,153

3,686

151,284

3,678

151,990

3,671

153,114

3,702

154,078

3,805

154,693

2.3

Basingstoke

1,938

97,159

1,930

98,665

1,927

100,161

1,939

101,640

2,021

102,980

2,047

103,527

6.5

Winchester/Andover

2,197

98,713

2,167

99,404

2,183

100,134

2,150

100,909

2,243

101,586

2,218

102,550

3.8

Eastleigh/Romsey

2,059

97,778

1,927

98,674

2,001

99,042

1,969

99,771

2,013

100,519

1,992

101,137

3.3

New Forest

1,972

96,564

1,961

97,337

1,978

97,986

1,940

99,192

2,002

100,217

2,055

101,359

5

Fareham/Gosport

2,432

111,511

2,404

112,128

2,461

112,997

2,457

114,300

2,544

115,370

2,608

116,155

4.2

Havant/Petersfield

2,264

102,015

2,252

101,973

2,205

101,979

2,192

102,248

2,243

102,393

2,305

102,643

0.6

Hampshire total

16,582

754,893

16,327

759,465

16,433

764,289

16,318

771,174

16,768

777,143

17,030

782,064

3.6

Source: Hampshire County Planning Department's 1997 Small Area Population Forecasts

Over this period, it is forecast that there will be an average increase in the adult population of Hampshire of 3.5%. This is not distributed evenly across the areas. Fareham/Gosport will see an increase of 4.2%, the New Forest, an increase of 5% and Basingstoke, an increase of 6.5%. On the other hand, Havant/Petersfield is only likely to see their population increase by 0.6%. As one of the Government's priorities is to reduce inequalities, this factor must be taken into consideration in the planning of services and distribution of staff.

Appendix 1 (Contd.) Prevalence Rates

Expected Prevalence Rates in Hampshire per 100,000 per year 1999

Social Services Area

Population 1999

Ages 18-65 years

People with MH problems in touch with services

10,000-25,000 per 100,000

People with severe mental illness

2,000-4,000 per 100,000

People with severe & enduring mental illness

300-1,500 per 100,000

Severely mentally ill who are difficult to engage

14-200 per 100,000

Alton/Aldershot

154,873

15,487 - 38,718

3,097 - 6,194

464 - 2,323

21 - 309

Basingstoke

99,097

9,909 - 24,774

1,981 - 3963

297 - 1,486

13 - 198

Winchester/Andover

100,910

10,091 - 25,227

2,018 - 4,036

302 - 1,513

14 - 201

Eastleigh/Romsey

99,837

9,983 - 24,959

1,996 - 3,993

299 - 1,497

13 - 199

New Forest

98,536

9,853 - 24,634

1,970 - 3,941

295 - 1,478

13 - 197

Fareham/Gosport

113,943

11,394 - 28,485

2,278 - 4,557

341 - 1,709

15 - 227

Havant/Petersfield

104,279

10,427 - 26,069

2,085 - 4,171

312 - 1,564

14 - 208

Hampshire total

771,475

77,144 - 192,866

15,425 - 30,855

2,310 - 11,570

103 - 1,539

Source: Keys to Engagement 1997 - Sainsbury Centre for Mental Health

Expected Prevalence Rates in Hampshire per 100,000 per year 2004

Social Services Area

Population 1999

Ages 18-65 years

People with MH problems in touch with services

10,000-25,000 per 100,000

People with severe mental illness

2,000-4,000 per 100,000

People with severe & enduring mental illness

300-1,500 per 100,000

Severely mentally ill who are difficult to engage

14-200 per 100,000

Alton/Aldershot

158,498

15,849 - 39,624

3,169 - 6,339

475 - 2,377

24 - 316

Basingstoke

105,574

10,557 - 26,393

2,111 - 4,222

316 - 1,583

14 - 211

Winchester/Andover

104,768

10,476 - 26,192

2,095 - 4,190

314 - 1,571

14 - 209

Eastleigh/Romsey

103,129

10,312 - 25,782

2,062 - 4,125

309 - 1,546

14 - 206

New Forest

103,414

10,341 - 25,853

2,068 - 4,136

310 - 1,551

14 - 206

Fareham/Gosport

118,763

11,876 - 29,690

2,375 - 4,750

356 - 1,781

16 - 237

Havant/Petersfield

104,948

10,494 - 26,237

2,098 - 4,197

314 - 1,574

14 - 209

Hampshire total

799,094

79,905 - 199,771

15,978 - 31,959

2,394 - 11,983

110 - 1,594

Source: Key to Engagement 1997 - Sainsbury Centre for Mental Health

Appendix 2

Mental Health Budget 2003-04 (Excluding Substance Misuse / HIV/AIDS)

Locality

Indicative Budget £'000

Agreed Local Underspend £'000

Budget Available £'000

Adult Population

(18-64 years)

Budget available per head of population £

 

 

 

 

 

 

Basingstoke / Alton

1,527.0

51.0

1,476.0

114,064

12.94

Aldershot

1,315.0

35.0

1,280.0

135,946

9.42

Winchester / Andover

1,437.6

39.0

1,398.6

107,360

13.03

Eastleigh / Romsey

1,021.5

0.0

1,021.5

101,344

10.08

New Forest

1,188.5

2.0

1,186.5

101,003

11.75

Fareham / Gosport

1,158.9

48.0

1,110.9

114,540

9.70

Havant / Petersfield

1,229.6

47.0

1,182.6

105,332

11.23

HQ

1,252.3

25.0

1,227.3

  

78.15

Total budget

10,130.4

247.0

9,883.4

 779,589

 12.68

Local Delivery Plan: Investment in the Key Mental Health Priorities (2003-06)

(Figures provided by Strategic Health Authority May 2003)

 

£000

Crisis Resolution

£000

Assertive Outreach

£000

Other Targets

Total

Blackwater Valley

290

  

20

310

North Hampshire

150

  

279

429

Mid Hampshire

  

50

118

168

Eastleigh Test Valley South

187

90

110

387

New Forest

68

  

28

96

Fareham & Gosport

  

127

14

141

East Hampshire

  

100

12

112

Total for HCC area

695

367

581

643

Southampton City

450

  

250

700

Portsmouth City

70

640

17

727

Isle of Wight

    

191

191

Total

1215

1007

1039

3261

Appendix 3

3. PERFORMANCE AND ACTIVITY

3.1 PAF DATA

Performance Assessment Framework (PAF) indicators relating to mental health performance are:

A6 - psychiatric readmission rates

B15 - unit cost of residential and nursing care in pounds per week

C31 - number of people helped to stay in own home (per 100,000 population)

C27 - number of adults (not mental health specific) admitted to residential care (per 100,000 population)

Performance is shown in terms of ·s, with one · = investigate urgently, and five · = very good performance

The returns for 1999-2000 and 2000/2001 indicate:

Indicator

Year 1999/2000

Year 2000/2001

Year 2001/2002

B15

£268.4

·

£372

·

£401

C27

3.9 (per 100k)

·

2.8

·

1.9

·

C31

1.0 (per 100k)

·

2.8

·

3.2

·

A6

Southampton & SW Hants HA

·

·

North & Mid Hants HA

·

·

Portsmouth & SE Hants HA

·

·

Hampshire & Isle of Wight Health Authority scored average at 14.8%

· B15 - GOOD. Hampshire Residential placement costs although slightly higher in 2000-1 than previously still remains acceptable and within the bottom two fifth of comparator Counties.

Band · - good performance.

    NOTE - However, within Hampshire there is significant variation in costs per area with Winchester/Andover, Basingstoke and Alton/Aldershot showing significant higher than other areas in both gross and net terms. Also, there is a relationship between cost and quality which needs to be balanced to achieve high standards together with efficient use of resources.

· C27 - GOOD. Hampshire is shown as successful in keeping people out of residential care with a rating of · - good performance 1999/2000, 2000/01 and 2001/02.

· C31 - GOOD. Hampshire has improved significantly in 2000/01, the indicator moving from · - low performance at 1.0, to · - good performance at 2.8 with further improvement in 2001/02 to 3.2. This commitment to improving community resources will be one of the most important factors in lowering the admission rate to residential care.

· A6 - This indicator is in the Health domain and data is collected for three (previous) Health Authorities covering Hampshire. In 1999/2000 and 2000/01 only Portsmouth and South East Hampshire HA were rated · - good performance, with Southampton and South West Hampshire HA and North and Mid Hampshire HA rated · - question performance. Hampshire & Isle of Wight Health Authority scored average at 14.8%.

3.2 NSF Stage 4 Monitoring

The traffic light framework for the self-assessment process, has a descriptive statement for each of forty one criteria. Individual LIT's score each criteria red, amber or green as appropriate for the statement which most nearly matches the local situation. The aim is to develop services which score `green', which indicates targets are or will be met within a set timescale.

Summary of Results for Hampshire LIT's.

Score

No.

Target areas

Commentary on progress since Sept. 2002

Red (LITs are all or mostly red)

16

    · Crisis Resolution

A Development Worker has been appointed working over several localities and once funding has been allocated work to progress this target can commence.

    · Early Intervention in Psychosis

A draft plan has been developed in south-east Hampshire

    · Black & Minority Ethnic People's services

Data collection has commenced in a number of LIT areas

    · Gateway Workers

Many localities have developed plans for improved Primary Care with full implementation awaiting funding

    · New Graduate Primary Care Workers

Many localities have developed plans for improved Primary Care with full implementation awaiting funding

    · Primary-Secondary Interface

Development needs to take place in this area

    · CPA - Access to Care Plans

Several areas can access care plans 24 hours per day with plans to be implemented for the remaining areas

    · CPA - Carer's Plans

A significant number of carers plans have been undertaken, but there was no amber option, with green signifying 100%

    · Transitional protocols

Draft protocols in place for some localities

    · Commissioning - Planning

LDP process will enable Local Implementation plans to be developed for each LIT

    · Commissioning Health Act Flexibilities

This forms part of the South East Development Centre programme for 2003/04

    · Local Strategic Partnerships

Significant progress has been made in several localities

    · Provision - CMHTs

Integration will be in place across the county by April 2003, with the exception of East Hants

    · Funding

Will become clear following the LDP process

    · Single sex accommodation

Several localities met this criteria but there is no amber option

    · Dual Diagnosis - LIT/DAT Interface

This is a DAT priority with work planned for 2003/04

Score

No.

Target areas/number

Commentary on progress since Sept. 2002

Amber (all or mostly amber)

20

    · Assertive Outreach

    · Secure Places

    · Women's services

    · Carer's services

    · Acute in-patient services - Acute care forums

    · Acute in-patient services - ward organisation

    · Prison services (MH)

    · CPA - comprehensive

    · NHS Direct

    · Planning processes

    · User Led services

    · Recruitment & Retention

    · Workforce Planning

    · Education & Training

    · Representative Workforce

    · Integrated MH. Electronic Record

    · Specialist services

    · Mental Health Act 1983 - Board Reports

    · Mental Health & Learning Disability

    · Section 135/136 - Places of Safety

These criteria scored "Amber" demonstrating that significant progress has been made towards developing services and meeting the targets

Green (all or mostly green)

5

    · CPA Information Sharing Protocols

    · Voluntary Sector

    · Links to LIS

    · Local Directories

    · Mental Health Promotion

These criteria scored "Green" demonstrating that the target has been fully met

Key Message

There are significant service deficits including key targets in the LDPs. Without PCT's prioritising mental health through appropriate financial investment the seven LITs in Hampshire are likely to fail to achieve key targets for mental health.

3.3 MENTAL HEALTH ACT ACTIVITY

Guardianship

31/03/01 - 31/03/02

30/06/01 - 30/06/02

No. new cases

15

12

No. discharged

11

10

Total at end

21

20

Supervised discharge

(Sec 25a)

31/03/01 - 31/03/02

30/06/01 - 30/06/02

No. new cases

7

13

No discharged

6

1

Total at end

22

30

Director appointed as Nearest Relative

31/03/01 - 31/03/02

30/06/01 - 30/06/02

No. new cases

1

1

Total at end

33

33

3.4 ASW Minimum Data Set returns

Period 1: 1st Apr 98 to 30th Sept 98 Period 2: 1st Oct 98 to 31st Mar 99

Period 3: 1st Apr 99 to 30th Sept 99 Period 4: 1st Oct 99 to 31st Mar 00

Period 5: 1st Apr 00 to 30th Sept 00 Period 6: 1st Oct 00 to 31st Mar 01

Period 7: 1st Apr 01 to 30th Sept 01 Period 8: 1st Oct 01 to 31st Mar 02

3.4.1 No. Approved Social Workers per area:

Trust Areas

Area

Period 1

Period 2

Period 3

Period 4

Period 5

Period 6

Period 7

Period 8

Period 9

ASWs by population period 9*

OOHS

12

11

11

10

11

7

6

0.48

Surrey Hants Borders

Aldershot

6

3

6

6

2.91

3.5

3

2.5

4.5 (1TM)

2.8

Basingstoke & Alton

9

11

8

8

10

9

9

7

9

3.7

West Hants Trust

Winchester & Andover

8

5

6

5

5

9

6.5

8

9

5.3

Eastleigh & Romsey

7

4

4

5

5.82

8

9

7

7

6.5

New Forest

7

7

7

6

7

7

6.5

7

8

4.7

Fareham & Gosport

7

5

4

3

4

3

5

3.5

4.5

2.4

Havant & Petersfield

3

5

4

3

4

5

4

4

4

2.4

Total

59

51

50

50

49.7

46

61

Ave:3.5

1 4ASWs - 3 part time & 1 full time - making 2.9 FTE ASWs.

2 7 ASWs of which 1 is a team manager & 3 part time - making 5.8 FTE ASWs.

3 Population figures reduced to two-thirds, to exclude Eastleigh Southern Parishes, no's not counted.

    · No. ASWs per 100,000 of the population

3.4.2 No. Mental Health Act Assessments per area

Area

Period 1

Period 2

Period 3

Period 4

Period 5

Period 6

Period 7

Period 8

Period 9

Assessments per 100,000 population for period 9.

OOHS

307 (25.6)

257 (23.3)

207 (18.8)

164 (16.4)

177 (16.1)

106(15.1)

187

15

Aldershot

N/A

15 (5.0)

41 (6.8)

64 (10.7)

59 (20.3)

46 (13.1)

48(16)

48(19.2)

40(8.9)

25

Basingstoke & Alton

110 (12.2)

79 (7.2)

97 (12.1)

71 (8.9)

105 (10.5)

87(9.7)

85(9.4)

70(10)

73(8.1)

30

Winchester & Andover

83 (10.4)

109 (21.8)

47 (7.8)

70 (12.0)

48 (9.6)

67(7.4)

66(10.2)

68(8.5)

65(7.2)

38

Eastleigh & Romsey

20 (2.9)

20 (5.0)

32 (8.0)

54 (10.8)

46 (7.9)

32(4)

44(5)

57(8.1)

34

31

New Forest

56 (8.0)

63 (9.0)

52 (7.4)

85 (14.2)

54 (7.7)

74(10.6)

42(6.5)

68(9.7)

71(8.9)

42

Fareham & Gosport

48 (6.9)

55 (11.0)

61 (15.3)

54 (18.0)

54 (13.5)

39(13)

55(11)

71(20.3)

47(8.5)

25

Havant & Petersfield

78 (26.0)

67 (13.4)

60 (15.0)

54 (18.0)

62 (15.5)

69(13.8)

57(14.3)

37(6.2)

67(11.2)

39

Total

*702

665

597

616

605

525

584

Average 37

1 This does not include numbers for the Aldershot area. It is therefore lower than would otherwise be expected.

3.4.3

3.4.4 Breakdown of Assessments by age & gender (From Period 4 onwards): Appendix 3

Assessment by age

Area

Adult

65+

<18

Period

4

5

6

7

8

9

4

5

6

7

8

9

4

5

6

7

8

9

OOHS

149

164

85

159

12

7

13

19

3

6

8

9

Aldershot

47

44

38

39

32

34

17

12

8

9

10

5

0

3

0

0

6

1

Basingstoke/Alton

48

76

56

52

51

50

23

28

31

31

19

20

0

1

0

2

0

3

Winchester/Andover

56

30

48

45

57

46

14

16

14

16

10

14

0

2

5

5

1

5

Eastleigh/Romsey

40

29

23

28

41

28

12

12

8

12

13

5

2

5

1

4

3

1

New Forest

64

36

61

34

52

53

20

15

10

8

16

18

1

3

3

0

0

0

Fareham/Gosport

37

38

26

40

48

33

17

13

12

13

23

12

0

3

1

2

0

2

Havant/Petersfield

43

50

52

43

25

48

11

11

17

13

9

17

0

1

0

1

3

2

Total

484

467

391

451

126

114

113

111

6

24

3

21

23

Percentage of Total:

79

77

74

20

19

22

1

4

3

4

Assessment by gender:

Area

Male

Female

Total

Period

4

5

6

7

8

9

4

5

6

7

8

9

4

5

6

7

8

9

OOHS

99

98

53

111

65

79

53

76

164

177

106

187

Aldershot

33

30

25

26

20

20

31

29

21

22

28

20

64

59

46

46

48

40

Basingstoke/Alton

33

48

42

35

26

28

38

57

45

50

44

45

71

105

87

85

70

73

Winchester/Andover

34

20

43

26

50

34

36

28

24

40

18

31

70

48

67

66

68

65

Eastleigh/Romsey

23

17

15

23

27

19

31

29

17

21

30

15

54

46

32

44

57

34

New Forest

41

29

39

17

35

41

44

25

35

25

33

30

85

54

74

42

68

71

Fareham/Gosport

26

28

13

28

42

17

28

26

26

27

29

30

54

54

39

55

71

47

Havant/Petersfield

38

37

38

29

26

37

16

25

31

28

11

30

54

62

69

57

37

67

Total

327

307

279

307

289

298

246

277

616

605

525

604

Percentage of Total:

53

51

53

47

47

47

100

100

100

100

100

3.5 CARERS DATA

The seven Carers Support Workers were recruited between January and May 2001 and since that time over 500 carers have been supported, offered a full assessment of their needs and received services.

Hampshire was awarded 4 blobs for the PAF D42 (Adults receiving Carer Assessments) indicator and had a very high performance in comparison with other authorities.

3.6 RESIDENTIAL CARE USE

3.6.1 Placements

Hampshire has been relatively successful in 2000/1 in preventing admission to mental health Residential care (National Statistics publication, 2000/1, Number of supported residents (by Local Authority))

In terms of placements, Hampshire has the second lowest number of placements in a range of nine neighbouring and comparator authorities.

% of Mental Health Placements as a % of total Residential Placements

for each Authority

England

4.3%

South East Region

3.6%

Shire Counties in S.E. Region

3.3%

Hampshire

2.8%

Kent, Surrey, West Sussex, Portsmouth, Southampton, Reading, West Berks, Wokingham

8.7% - 2.7%

2000/01 Total number of placements 145

                      Number of placements `In County' 107

                      Number of placements `Out of County 38

3.6.2 Cost

The cost of residential and nursing care for adults with mental health problems is substantially lower than for adults with a learning or physical disability.

Unit Costs for England 2000/1

Residential and Nursing Care for Adults

Mental Health

£418

Learning Disability

£644

Physical Disability

£516

Comparison with the official comparator group of fifteen Shire counties in 2000/01 regarding the weekly unit cost of supporting mentally ill adults in Residential and Nursing care (Personal Social Services expenditure and unit cost: England 2000/1):

    o England - £412

    o Hampshire fifth lowest unit cost out of 15 Shire Counties

    o Hampshire unit cost is £372.04 in range of £205.74 - £639.58.

· Total Cost in 2000/01 - £2,669,000 (gross), £1.563,000 (net)

Hampshire weekly rate:

For Residential Care - £247

For Nursing Care - £357

· % `In County' 54%

    placements above the HCC weekly rate

· % `Out of County' 52%

placements above the HCC weekly rate

3.6.3 Location

    2000/01 Total number placements `In County' `Out of County'

        145 107 38

              Percentages 100% 74% 26%

Although there are in total 38 Out of County placements, (26% of total placements), given the geographical size of Hampshire and the recent Local Government reorganisation, the vast majority of placements are as "close to home as possible" and therefore could be seen to meet the NSF requirement, e.g. Alton clients placed in Surrey, New Forest clients placed in Bournemouth.

Neighbouring Authorities

  

Other Authorities

  

Surrey

Wiltshire

Southampton

Portsmouth

Bournemouth

Total

6

6

7

4

7

30

Devon

Somerset

Gloucestershire

Leicester

London

Total

3

1

1

1

2

8

Appendix 4

MENTAL HEALTH TRAINING PLAN 2002/3

  
     

ITEM

BUDGET ALLOCATION

FUNDING SOURCE

     

Management & Administration

  

Mental Health Grant

Mental Health Awareness

 

Mental Health Grant

Certificate in Community Mental Health Care

  

Mental Health Grant

Service user / carer training

  

Mental Health Grant

Integration and CMHT Development

 

Mental Health Grant

Locally managed budgets

  

Mental Health Grant

Post Qualifying Social Work training

  

Mental Health Grant

Direct Payments training

 

Mental Health Grant

Training for care coordinators

 

Mental Health Grant

Housing, benefits and employment

Child protection for mental health workers, adult protection, domestic violence

 

Mental Health Grant

Service user at the centre

 

Mental Health Grant

Sub Total

£130,000

  

ASW including backfill

  

Training Support Grant Main Programme

Social Supervision of Conditionally Discharged Restricted patients

  

Training Support Grant Main Programme

Preparing reports for mental health review tribunal

  

Training Support Grant Main Programme

ASW practice development days

 

Training Support Grant Main Programme

ASW Law Refresher

  

Training Support Grant Main Programme

ASW refresher - substance misuse

  

Training Support Grant Main Programme

ASW refresher - working with older people

  

Training Support Grant Main Programme

Sub Total

£100,000

  
     

Total projected spend

£230,000