Agenda item

This paper provides an update in relation to Mental Health Services.

The Chair introduced the item which provided an update on mental health services during the Covid-19 pandemic. It was noted that the Committee had received the written report and the presenters were invited to highlight any key points. The Chair also congratulated Jinjer Kandola on her recent MBE for Services to Mental Health. Jinjer Kandola, Chief Executive for Barnet, Enfield, and Haringey (BEH) Mental Health Trust, and Andrew Wright, Director of Planning and Partnerships for BEH Mental Health Trust, introduced the report.

It was noted that there were currently more Covid-19 outbreaks in wards and among NHS staff as the new variant of the disease was more transmissible; this included up to 11% of staff unwell or self-isolating. Unlike the first wave of the disease, it was explained that there had been less of a reduction in the number of people accessing mental health services. However, it had been necessary to temporarily close some beds as a result of infection prevention control measures and there had been a need to use some out of area placements which was less desirable.

The Committee enquired whether there had been any decreases in service use for any services that had changed. Jinjer Kandola highlighted that all mental health staff had worked exceptionally hard to ensure that all NCL services continued throughout the pandemic. It was noted that there had been some service transformation during the Covid-19 pandemic and this included a single point of access for referrals, a new process for entry to A&E where patients were seen in a dedicated area by specialist staff, a new 24 hour telephone helpline with previous telephone numbers forwarded to the new number, and additional support for Black, Asian, and Minority Ethnic staff as well as other staff at higher risk. It was added that digital services were offered based on patient choice, specific work was undertaken to support those who were shielding, and all community case loads were assessed, risk rated, and prioritised accordingly. It was explained that there had been a focus on appropriate discharging and winter funding had been used to work with Mind and other organisations to ensure that people had the care they needed.

Cllr das Neves noted that future plans for health care would be managed at NCL level under the Integrated Care System (ICS) and it was enquired how it would be possible to find a balance between consistency and tackling local issues with specialised care. Jinjer Kandola explained that residents felt that they lived in a neighbourhood rather than a borough and it was important that care was delivered in this way. It was highlighted that the long term plan aimed to ensure that there was a consistent model in all five boroughs but that local specialisation would be possible. The Chair noted that it may be appropriate to discuss this issue at the Committee’s special meeting on ICS in March 2021.

Cllr Revah enquired what support was being provided to staff and others impacted, such as carers. Jinjer Kandola explained that there was an online platform to support NCL staff which had a variety of options. It was acknowledged that carers had often taken on additional responsibilities where Voluntary and Community Sector (VCS) provision had been closed or suspended during the pandemic. It was noted that there were some support packages and assessments available for carers but it was understood that there may be a need for a better ongoing support package.

The Committee noted that the Covid-19 pandemic had seen a significant mental health impact, including an increase in people attempting suicide during the pandemic. It was believed that preventative work, such as Talking Therapies, was key but that there was an inequality of access for some communities, particularly for Black people. It was added that councillors and community organisations could assist with contacting local communities. Jinjer Kandola explained that part of the mental health services transformation would be to better understand health inequalities and the first step in tackling this issue would be to identify why certain people were not accessing services. It was highlighted that this would involve a deep analysis of specific, constituent ethnic and other groups and how they accessed services. This would allow a better understanding of how care could be delivered differently to ensure access for different groups. It was added that the move towards an ICS aimed to provide consistency and retain a close relationship with local government and VCS groups who were often best placed to advise on or deliver services.

The Committee asked what beneficial changes had emanated from the Covid-19 pandemic and how mental health services were liaising with community services like Mind. The Chair noted that the Committee would like to receive an update on any situations where mental health services were working innovatively and where services were targeting any particular groups to increase uptake.

Cllr Smith noted that it was reassuring to hear that the service was delivering well despite the difficulties caused by the pandemic and that there were plans to equalise funding for services for outer London. It was enquired what the current and future spending per capita would be across the boroughs. Cllr Hamilton noted the link between mental health and homelessness and enquired what support was available for the homeless. Andrew Wright explained that work was ongoing with various providers but that this was one area where the response varied in different boroughs. It was added that this was an important priority in NCL and it was hoped that the move to a NCL-wide approach would assist in ensuring consistency. The Chair noted that it would be helpful for the Committee to receive additional information on per capita funding in different boroughs and on homelessness.

The Chair noted that individuals who required mental health services often had complex needs and were likely to come into contact with a number of other services, including local government and police services. It was explained that it was difficult for residents to know which service was relevant or would take the lead. As part of an update to the Committee, the Chair stated that it would be useful to understand how various services worked together. Jinjer Kandola stated that, as part of the longer term changes in NCL, the ICS would aim to provide integrated care, wrapping care around individuals. This would involve an assessment for individuals and a decision about who would co-ordinate their care; it was explained that care could be led by mental health, physical health, or social care depending on a person’s needs. It was acknowledged that this model needed greater development and planning and that it could be useful to have a future session where the Committee and other partners could provide input.

RESOLVED

1.    To note the report.

2.    To receive an update on mental health services, specifically providing more information on funding for individual boroughs and homelessness.

3.    To receive a response on the question of who was leading on co-ordinating all the different services in relation to mental health care, including other partners such as the Police, housing, and the Council, within individual complex cases. It was acknowledged that this model needed greater development and planning and that it could be useful to have a future session where the Committee and other partners could provide input.

4.    To receive an update on any situations where mental health services were working innovatively and where services were targeting any particular groups to increase uptake.