Report of the Associate Director of Operations, Greater Manchester Mental Health, NHS Foundation Trust

This report provides a summary of the services provided by Greater Manchester Mental Health and provides an overview of the activity across the footprint in Manchester.  

The Committee considered the report of the Associate Director of Operations, Greater Manchester Mental Health, NHS Foundation Trustthat provided a summary of the services provided by Greater Manchester Mental Health and provided an overview of the activity across the footprint in Manchester.  

Key points and themes in the report included:

·         An overview of Mental Health Crisis Services;

·         An overview of Community Services, including the actions taken from a recent CQC inspection and regulation 29a notice within two Community Mental Health Teams.

·         Inpatient Service provision; and

·         An update on the Healthier Patient Pathways Programme.

Some of the key points that arose from the Committee’s discussions were: -

·         What work was being done with Greater Manchester Police (GMP) to support people who were experiencing a mental health crisis;

·         Was the 24/7 Helpline monitored and what was done to ensure any missed calls were responded to;

·         Was the Helpline available for family and carers to access;

·         What support was offered to families and carers of residents experiencing mental health issues;

·         Noting that the building was to commence at South Manchester, Wythenshawe Hospital Site to support replication of the North Manchester General Hospital (NMGH) site Mental Health urgent care area with completion expected December 2022;

·         Would there be a bespoke ‘Green Room’ at the Wythenshawe site, similar to that at North Manchester General Hospital;

·         Calling for an appropriate urgent care “Green Room” to be initiated at the Manchester Royal Infirmary site as a priority;

·         Where would Wythenshawe residents experiencing a mental health episode currently receive treatment, adding that transferring patients to North Manchester General Hospital was not appropriate for patients and their families;

·         What quality assurance measures were undertaken of those Voluntary Community and Social Enterprise (VCSE) groups working in community settings; 

·         What was being done in regard to staff recruitment and retention;

·         What was being done to address barriers arising across services in relation to data sharing; and

·         Who were responsible for arranging who accessed the crisis beds for Manchester residents.

In response the Associate Director of Operations, Greater Manchester Mental Health NHS Foundation Trust advised that the Trust remained committed to working with GMP to offer the most appropriate response to an individual in crisis. He stated that a pilot scheme with staff seconded to support GMP was currently underway over the winter period and this pilot would be evaluated in March 2023. He advised that this approach was a demonstrable commitment to delivering the Long Term NHS Plan. He stated that in addition to this pilot regular meetings were convened with GMP and there were mechanisms established for escalating issues.

The Associate Director of Operations, Greater Manchester Mental Health NHS Foundation Trust stated that, contrary to national figures, Manchester had witnessed a reduction in the numbers of people attending A&E when experiencing a mental health crisis. He advised that Wythenshawe patients would be treated at Wythenshawe Hospital as they had an inpatient facility, however on the occasions beds were full they would be transferred to NMGH. He advised that at the time of addressing the Committee there were no patients outside of their locality. The Associate Medical Director, Greater Manchester Mental Health NHS Foundation Trust added that this situation was reviewed on a daily basis and every effort was made to relocate a patient closer to their home address when it was appropriate to do so. He added that partners worked closely across all systems to improve the patient experience and reduce system created barriers.

The Associate Director of Operations, Greater Manchester Mental Health NHS Foundation Trust stated that the Helpline answer machine was routinely monitored. He added that the Helpline had been audited by the NHS and the Trust had received very positive feedback on this provision. He stated that friends and carers could also use the Helpline and if appropriate people would be signposted to other sources of appropriate support and advice. He noted the comment regarding additional support for families and carers and added that it was recognised that more needed to be done in regard to this. He noted the issues experienced by some Members in relation to the Helpline and commented that if they contacted him outside of the meeting he would look into the specific cases.

The Associate Director of Operations, Greater Manchester Mental Health NHS Foundation Trust advised that the monitoring of VCSE groups in communities was achieved through the standard contract management arrangements, and these were complemented by visits and regular meetings with providers.

The Associate Director of Operations, Greater Manchester Mental Health NHS Foundation Trust commented that the issue of staff recruitment and retention was a national issue, however work was ongoing with their Human Resources department and a working group had been established to address this. In addition, work was underway with Health Education England to encourage students and existing health professionals to consider alternative roles in the health service. He further referred to the recent Staff Survey that had improved significantly since previously reported to the Committee, and the intention was to build upon this to support staff retention. The Associate Medical Director, Greater Manchester Mental Health NHS Foundation Trust stated that five Consultants had recently been recruited and there were a range of initiatives to support retention of staff.

The Associate Director of Operations, Greater Manchester Mental Health NHS Foundation Trust informed the Members that the Home Based Treatment Teams would make referrals to the crisis beds. He stated that the Home Based Treatment Teams were important as they prevented hospital admissions and supported people to leave acute settings in a managed way with the appropriate planning and support. He advised that people could self refer to the Crisis Cafes, noting that there was one in Harpurhey and another in the city centre, adding that these were staffed by VCSE groups and a Mental Health Practitioner.

In response to a question regarding managing demand he reiterated that delivery of both the NHS Long Term Plan and Living Well models of care across all GMMH localities was key to managing demand. He further advised that a business case had been prepared to support the Primary Care Network, again adding that this partnership approach was key to managing demand. In response to comments from the Chair he stated that Trauma Informed Practice was embedded in the Living Well models of care and was also included in staff training.

The Executive Member for Healthy Manchester and Adult Social Care noted that the report and answers provided had been honest and open and had contributed to a constructive conversation with the Committee. He made reference to the point raised by the need for a partnership approach and made reference to the support offered by Manchester City Council following the CQC inspection.

The Committee requested that, following the meeting, information be circulated that described the referral system to Crisis Cafes and analysis by ward and ethnicity of those accessing the service; information in relation to the cultural diversity training provided to the Home Based Treatment Teams;  that the Community Mental Health Team resilience plan agreed in September 2022 in response to the CQC inspection be shared; the terms of reference for the Clinical Risk Assessment workshop and any outcomes be shared; the terms of reference of the task and finish group that had been established to progress further areas identified for improvement in telephony systems and processes within Manchester be shared, and information on the recruitment and role of admiral nurses be provided.

Decisions

1.            The Committee support the call for an appropriate urgent care “Green Room” to be initiated at the Manchester Royal Infirmary site as a priority.

2.            The Committee recommend that the additional supplementary information requested at the meeting is provided to the Scrutiny Support Officer so this can be circulated to all Members of the Committee.