Agenda item


To update the Committee on the progress of the mental health services review and next steps including the work to develop a set of mental health indicators and to agree Borough based implementation plans.


Dr John McGrath, an Islington GP and Clinical Representative on the NCL CCG Governing Body, introduced this item. Adding to the information already provided in the agenda pack, Dr McGrath observed that he saw this review as part of a bigger puzzle, along with the Community Services Review, about the link between how people experience good mental health and how people experience good physical health. Other elements included the community mental health framework transformation, which involved aligning mental health professionals with primary care services and working with providers on the intended outcomes from services. Through the baseline review of NCL mental health services, the current baseline position had been set out and a core offer developed to establish a minimum entitlement for NCL residents. The core offer included a single point of access with a single up-front holistic assessment of health needs, with multiple avenues of access, meaning that people did not necessarily have to go through their GP. Service users with complex needs would be provided with personalised care planning.


Dr McGrath added that, in a post-pandemic world, the societal consequences and the impact of the pandemic on mental health needed to be recognised and that support from the voluntary and community sector was important, as well as from statutory mental health services.


Dr McGrath and Sarah Mansuralli, Executive Director of Strategic Commissioning at NCL CCG, then responded to questions from the Committee:

  • Asked by Cllr Tomlinson for further detail on the proposed ‘single point of access’, Dr McGrath said that the strategic view should be allowing a model that works, so that this could differ between boroughs. In Camden, for example, there was a website which hosted mental health resources and directed people into the different levels of mental health support that was available. Whichever model was used, the aim would be to ensure that a resident knows where to go to access support.
  • Asked by Cllr Tomlinson for further detail on the use of technology to reduce the need for patients to explain their situation multiple times, Dr McGrath said that the ambition was to progress this at pace, but that it was also important to ensure the safety of data transfer between organisations, particularly because of patient anxieties about where the information was stored. There were now digital platforms such as “Patient Knows Best” which enabled health information to be shared securely with healthcare professionals.
  • In response to a query from Cllr Tomlinson about the role of GPs, Dr McGrath acknowledged that mental health was a huge part of the clinical workload of GPs, not just in terms of the conditions themselves, but also because of the impact of psychological ill-health on the management of long-term physical health issues. What was envisaged was a much closer linkage between GPs and the vast array of non-statutory mental health support provided by community and voluntary organisations and to make use of the links between physical health, primary care, early intervention and mental health support. 
  • Asked by Cllr Cornelius about the case for change, Dr McGrath responded that gap analysis had been carried out on existing conditions in the boroughs a which highlighted the differences between boroughs and the gaps that needed to be addressed. Cllr Clarke observed that deprivation was clearly linked with mental health and distress and emphasised the importance of community organisations in providing support to residents, as well as the role of talking therapies. Dr McGrath concurred with this, adding that the emphasis needed to be on community wealth building and relationships in the community, including cultural competency and an awareness of the lasting impact that the pandemic had caused on mental health and wellbeing.
  • Asked by Cllr Connor about co-production and the role of residents, Sarah Mansuralli said that co-production was discussed a lot, for example when developing personalised care plans. The issue was then how to mainstream co-production and to do this in a more consistent way at different levels. There was further work to do, including by enabling experienced service users to actively participate in discussions.
  • Cllr Connor noted that the report on page 5 of the agenda pack referred to Children and Adolescent services being particularly fragmented and requested that further detail on this be provided in the next report. (ACTION)
  • Cllr Connor asked whether there were any plans to join up services provided by Barnet, Enfield and Haringey Mental Health Trust (BEH-MHT) with those provided by Camden and Islington NHS Foundation Trust. Dr McGrath said that he had noticed an increased ability for communication across the organisations about care and service design along with a clearer idea of trying to ensure a consistent offer across the NCL population. Sarah Mansuralli added that there was now closer collaboration the two organisations and, while they remained as two distinct organisations, they now had a joint Chief Executive and were moving towards a joint management team. This enabled better analysis of the available beds across both sites for example, which enabled mutual aid with patients in the north accessing services in the south and vice-versa. This collaboration would be built on through the review.
  • Cllr Connor noted that the report on page 8 of the agenda pack referred to service users with complex needs being allocated a clinical case manager. She added that local Councillors were often made aware about concerns relating to individuals with high mental health needs and it could be difficult for Councillors to know who to contact for assistance as the individuals were usually in contact with multiple agencies. Dr McGrath said that complex cases were often dealt with by multiple agencies, including through a MARAC, and that the intention of the coordination referred to in the report was to bring statutory and voluntary services together under a case manager so that people were not bounced around so much. Cllr Connor said that this case management aspect was an area of particular interest to local Councillors and requested that the Committee be kept updated on this at future meetings. (ACTION)
  • Cllr Cornelius raised the use of ‘mental health champions’ within local authorities as a way of helping to raise the profile of the issue and to link local individuals and organisations with services.



That a future update report on the issues discussed should be provided to a future meeting of the Committee to include details on:

  • How information on available services is communicated to residents;
  • How co-design/co-production is embedded, with examples of how this was working in practice;
  • Child & Adolescent mental health services and how the fragmentation of services (as referred to in the report) was being addressed;
  • The closer working relationship between BEH-MHT and C&I NHS Trust;
  • A single point of communication for queries relating to service users with complex needs.


Supporting documents: