Appendix B Leeds Mental Health Teaching NHS Trust Briefing Paper for Scrutiny Board (Health and Adult Social Care) 19 June 2006 1. Introduction This paper describes the role of the Trust, its key challenges and ambition for the future. Not the least of these is our current pursuit of Foundation Trust status. Through Foundation status the Trust will benefit from wider engagement and involvement with its stakeholders, not only in terms of services it will deliver but also in the ongoing development of the organisation`s strategic direction. The Trust has worked hard at moving from a position of financial dependence in the past to one of actively supporting the local health economy in the present. The Trust is now able to focus solely on moving forward in terms of service quality improvement, linked to value for money, without the burden of short-term financial handling strategies. This has provided tremendous motivation for those involved in delivering services within the Trust. Key to the Trust`s success will be its continuing engagement with service users and carers, the wider community and our partner organisations, both statutory and non-statutory, and these themes are addressed further in this paper. Our future direction is encapsulated in our ambition statement that: “In 2011people choose our Foundation Trust because we always deliver the best mental health and learning disability care” 2. Background Leeds Mental Health Teaching NHS Trust is a provider of specialist mental health and learning disability services. The Trust provides services to over 715,000 people within the metropolitan boundaries of Leeds. Specialist services accept referrals from across the UK. We operate from over 70 sites and provide help to over 2,000 people every day. Our current service user population who are registered as involved in the Care Programme Approach is in excess of 16,000. The Trust is also a centre for teaching, research and development. Service provision is currently divided into five areas which are: • Working Age Adults • Older People • City wide • Learning Disabilities • Addiction June 2006
Appendix B 3. Overall Vision for Mental Health Services in Leeds The overall vision of Leeds Mental Health Strategy is to improve the health and well being of people with mental health problems and their carers in ways that are determined by them; and to promote mental well being of the population as a whole. The following guiding principles are intended to act as a foundation for the future and become part of the way the partnership does things and how it should be judged for what it delivers. • Services adopting a positive and hopeful recovery perspective • Prevention of mental health problems and promotion of mental health • Services being guided by transparency of purpose • Linking with and influencing broader services and strategies • Services that ensure no harm is done • Services that offer the lowest level of intervention possible • Services assessing risk with the person concerned • Acknowledging that mental health problems may be complex and multifaceted • Aligning success criteria • The service users for individual care plans should determine success criteria • Joint approaches to planning and delivery • Service evaluation • Links to other strategies and work streams This strategy is set within the context of other key strategies in the city notably the Strategic Services Plan (Making Leeds Better), Vision for Leeds 2, Leeds Housing Strategy, local implementation of strategies for older people, NSF for older people, CAMHS strategy, Valuing People Strategy, Black and Minority Ethnic (communities) Mental Health Strategy, Women’s Mental Health Strategy, Supporting People Strategy and the Drugs Treatment Plan. 4. Service Development Plans In 2006/07, work is or will be taking place as follows: 4.1 Working Age Adults • A key element of service redesign has been the implementation of a single management structure to support the functional model of service delivery. To support this approach and to ensure the whole system of mental health care can support this process, comprehensive service specifications detailing service roles and access criteria will be produced and agreed with commissioners • Restructuring of acute community day services (ACDS) was completed in 2005. There are 5 acute community day treatment centres across June 2006
Appendix B the city offering locally accessible acute care, either by preventing admission at the point of crisis assessment or by facilitating early discharge from an acute inpatient bed. The south Leeds ACDS was successfully relocated to suitable premises in Beeston in March 2006. There are plans to relocate the East Leeds service (which is inappropriately located on an inpatient unit) to a site in Seacroft subject to full planning permission and the requisite capital funding. • A multi agency group established between the Trust, PCTs, the Police and Social Services has been meeting to provide a fast and efficient procedure for assessing those individuals who have been arrested under Section 136 of the Mental Health Act. A further development will see the in-reach service provided by the Crisis Resolution Team extended to provide full 7 day cover over 24 hours. Furthermore, a capital bid has been made to the Department of Health to enable a place of safety to be provided on Trust premises in line with latest policy • The Trust and the commissioners have been in discussions about improving continuing treatment and recovery services in Leeds and obviating the need for patients to be sent out of area. A significant assessment of individual patients was concluded in 2005/06 and this is informing the work now being undertaken to produce a service model and subsequently a robust business case • Improved access to psychological therapies is an increasing priority and the Trust has been working closely with the PCTs to develop a whole system approach to delivering a “stepped care model”. Throughout 2006/07 the Trust and PCTs will continue working in partnership in developing and implementing new models of service delivery for psychological therapy services 4.2 Older People • Older people`s mental health services in Leeds have received long awaited recognition in the past year and the main focus in 2006/07 will be to implement the successful Partnerships for Older People`s Projects (POPPs) programme. However, this work cannot stand in isolation and needs to be part of a fully redesigned service built around a rehabilitation and recovery model, incorporating local and national strategies and guidance. This model includes the provision of care as near to the service user as possible and the transfer of services into the community • Liaison Psychiatry – This team operates like a community mental health tem but within the general hospital. The POPPs project will see this service extended city wide and it will also develop a presence in A&E departments, working closely with other liaison services June 2006
Appendix B • Rapid Response - crisis situations can often be managed without a person going into acute care by the provision of a rapid response service. Rehabilitative and therapeutic services can be provided within the older person`s own environment. In addition, the service will enable earlier discharge from hospital by providing the option of rehabilitative care within the community. Within POPPs, mental health intermediate care teams will work in partnership with, and where possible, be co- located with the existing intermediate care teams • Service Redesign – In order to release further investment for community development, the Trust is consulting on the transfer of services from one of its community units since a significant number of patients have been assessed as no longer requiring NHS inpatient care but are awaiting placement in appropriate residential or nursing homes. The overall investment in services for older people will not be decreased but will be targeted more effectively to better meet people`s needs within the community 4.3 City Wide • To enable a step down from our low secure facilities, provide throughput capacity and improve rehabilitation services, the Trust will be reopening the Beeches to provide a rehabilitation facility for 8 male patients. Building work has just commenced and the service is likely to be operational at the end of September • In 2005/06 the Eating Disorders service was moved from inadequate accommodation at Seacroft Hospital to a vacant ward within the Newsam Centre. That enabled an increase in beds to be made to meet regional demand and the service has proved very successful. In 2006/07 consideration will be given to the potential for further increasing the bed base as well as developing the centre`s research and consultancy role 4.4 Learning Disabilities • The service has just completed a strategy for NHS Learning Disability services for consideration and agreement within the Trust and with our commissioners and partner organisations. The aim is to set a clear direction for the development and improvement of services and create the capacity to bring suitable clients back to Leeds • The Trust will work in partnership with the joint commissioning service to develop plans that ensure community services are able to meet the changing demographic needs of the learning disability population. The focus will be particularly on prevention and meeting complex needs such as autism and early onset dementia. June 2006
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