Archived decisions

Contact: Anthony Lane

1. Summary

This briefing note covers the following information with a requested update to the review of Mental Health Advocacy from the Safe and Healthy People Select Committee on 29 October 2008:

- An overview and clarification of Advocacy areas in Mental Health

- The background to and outcomes from the review of generic Mental Health Advocacy Service

- Generic Mental Health Advocacy Service and how it links to the Independent Mental Health Act Advocacy (IMHAA) service commissioned by NHS Hampshire (formerly Hampshire Primary Care Trust) and the Independent Mental Capacity Advocacy (IMCA) service.

2. Recommendations

a) The Safe and Healthy People Select Committee are asked to note and comment on the contents of this report

3. Background

As of the 1^st of April 2009, Advocacy in the area of Mental Health has three main components. These services have close links and liaison, but are separate services:

· Generic Mental Health Advocacy Service

· Independent Mental Health Act Advocacy (IMHAA) Service

· Independent Mental Capacity Advocacy (IMCA) Service

3.1 Generic Mental Health Advocacy - Prior to April 2009, A generic Mental Health Advocacy Service was jointly commissioned from four providers by Hampshire County Council, Adult Services Department and NHS Hampshire. This service provided advocacy to those adults with mental health needs known to the secondary mental health services. This service was available to people, whether living in the community or in an in-patient unit as an informal patient. The contract for this service ended on 31st March 2009.

3.2 Independent Mental Health Act Advocacy (IMHAA) Service - Specialist independent mental health advocacy service for patients in the Hampshire Partnership NHS Trust's general adult psychiatric hospitals which are located throughout Hampshire. The IMHAA service is being commissioned by NHS Hampshire (Hampshire PCT) in a spot purchase framework to meet the needs of People 18 years and over who are detained under the Mental Health Act. The Service commissioned by NHS Hampshire will anticipate and meet the requirements for Independent Mental Health Advocates (IMHA) under section 130A of the Mental Health Act 2007 and commenced from 1^st April 2009.

3.3 Independent Mental Capacity Advocacy (IMCA) Service - Report given to Safe and Healthy Select Committee 29 October 2008. The IMCA service was introduced as part of the Mental Capacity Act 2005 (MCA) which came in to force in April 2007. The IMCA service is intended to provide representation of the wishes and feelings of people who lack capacity, when they have no-one else to speak for them and they are having specific decisions made for them. The MCA introduced a legal duty on decision-makers to instruct advocates from the IMCA service when they are making decisions for unbefriended people about where they should live and whether or not they should have serious medical treatment. There is also a discretionary power to instruct an IMCA when there are safeguarding adults proceedings involving people who lack capacity.

4. Outcomes from review of the generic Mental Health Advocacy Service

4.1 With the NHS Hampshire commissioned IMHAA service and anticipated changes under section 130A of the Mental Health Act coming into effect from 1^st April 2009 - a review of the generic Mental Health Advocacy Service was undertaken in the Summer of 2007. Information from this review and general feedback around Mental Health Advocacy indicated there were potential gaps in service coverage and availability in the County and variations in service quantity, quality and consistency.

4.2 The generic Mental Health Advocacy Service was advertised for tender by Hampshire County Council with expressions of interest requested in July 2008.

The start of the standard Hampshire County Council Tender process was then set in place with the following timescale and sequence:

4.2 Tender results

The tender process from July 2008 to November 2008, led to the appointment of two organisations to provide generic Mental Health Advocacy services across Hampshire.

· Solent Mind was appointed for the South East and West Local Implementation Team (LIT) area for a contract period of two years with an option to extend one year.

· Basingstoke Advocacy Scheme was appointed for the North and North/East LIT area for a contract period of two years with an option to extend one year.

5. Conclusion and Next steps

5.1 In comparison with other areas across the country, there has been positive development for Advocacy in the Mental Health area in Hampshire. There is excellent joint working with NHS Hampshire, with the Hampshire IMHAA service specification being noted and making a contribution to the work of the Care Services Improvement Partnership (CSIP).

5.2 The generic Mental Health Advocacy service will continue to receive close contract monitoring and multi-agency input from the Mental Health Advocacy group as a multi-agency advocacy steering group. The steering group will ensure that the service is able to meet the challenges and developments in Advocacy areas, including the new NHS Hampshire provision of IMHAA services and the continued work of the IMCA service.

The Mental Health Advocacy group will meet on a bi-monthly to quarterly basis and will contribute to regular contract monitoring of the generic Mental Health Advocacy Service to ensure effective service development to meet need and provide positive outcomes.