Agenda and minutes

To hear apologies from members unable to attend.

Apologies were received from Councillors Blakemore and Bond and Co-optee Martyn Kingsford.

In accordance with the Members Code of Conduct, Members are requested to declare any interests orally at the start of the meeting and again immediately before consideration of the matter.  Members are reminded to specify the agenda item number to which it refers and whether the interest is of a personal or prejudicial nature.

Elected members are also reminded of the requirements of Section 106 of the Local government and Finance Act 1992 that they should declare and not vote on specified matters if they are two months or more in arrears with their Council Tax payments.

Co-optee Margaret Dangor declared a personal interest as the wife and carer of a user of Mental Health Services in the Borough.

Councillor Bouchier declared a personal interest as a member of the board of Age UK.

To approve the minutes of the previous Health, Housing and Adult Services Overview and Scrutiny Committee meeting, held on 14 September 2011.

The minutes of 14 September were agreed as a correct record and the Chairman authorised to sign them with the proviso that comments be received from Councillor Mathias who was not present for this item.

To receive reports of the Head of Joint Commissioning for Mental health and Substance Misuse providing updates on the current status of the Mental Health Strategies for Adults and Older People.

Dominic Wright, Director of strategy and Commissioning and Cathy Kerr, Director of Adult and Community Services, LBRuT will be in attendance to speak to this item.

The Committee agreed that items 4a) and 4b) be heard together. 

The Committee received two reports of the Head of Joint Commissioning for Mental Health and Substance Misuse, the purposes of which were to provide further updates on progress and future plans to implement the Richmond Adults Mental Health Joint Commissioning Strategy and the Richmond Older People’s Mental Health Strategy since the report received in April 2011.

The Director of Adult and Community Services, LBRUT, Head of Joint commissioning for Mental Health and Substance Misuse and the Managing Director of NHS South West London Richmond Branch attended to speak to the items.  In particular the following points were reported:

(i)      That the strategies set the framework for the Borough within which the Mental Health Trust worked as the Borough’s main mental health service provider.

(ii)    That the implementation of the strategies had been slightly delayed owing to staffing issues which had now been resolved.

(iii)   Both strategies had been refreshed to reflect the changing NHS landscape.

(iv)  The three main strands of the Adult Strategy were:

·         Community Mental Health Services
Including enhanced support services for GP’s and other support services such as MIND

·         Recovery and Rehabilitation Services
The Borough’s historic arrangements would need to be addressed in order to conform to national policy

·         Adult Acute Inpatient Beds
The need for inpatient beds was recognised but provision would need to be reconfigured in order to reflect the improvements to Community Services and to create economies of scale for the Borough’s within the South West London cluster.

(v)    The main strands of the Older people’s strategy were:

·         Development of a Memory Service

·         Dementia Training and Information

·         Intensive Home Treatment Team

·         In-patient Beds and the level of service required

(v)    Operationally these strategic aims had resulted in the establishment of a Memory Clinic to be opened at the end of 2011, Intensive Home Treatment Services based on the successful Sutton model and the preparation for consolidation of Outreach Services.

(vi)  NHSSWL had driven the approach contained within the strategy in particular the towards community provision to improve care and reduce the need for inpatient beds.

(vii)It was confirmed that a ‘joined up’ approach to community work was being adopted across the NHS and Local Authority.

In response to comments made and questions raised the committee heard that:

(a)   That the approach towards community care was not a new one but that recent economic developments nationally and the implications of the Foundation Trust application for the mental health trust brought new importance to this approach.

(b)   That GP’s were supportive of the direction taken and work was underway to create a strong infrastructure in order that the new commissioning system would work when introduced.

(c)   That work was being undertaken with providers to look for properties that could be developed in order to house mental health patients in the borough and that all partners were committed to funding this work together. Currently two properties were under consideration and work would progress on  ...  view the full minutes text for item 97.

To receive a report of the Service Director for South West London and St George’s Mental Health Trust providing an update on inpatient services and links to site issues across the cluster.

Sue Denby, Kingston and Richmond Service Direct and Kim Goddard, Director of Nursing and Operations, of South West London and St George’s Mental Health Trust will be in attendance to speak to the item.

The Committee received a report of the South West London and St George’s Mental Health Trust Service Director, the purpose of which was to provide an update to the Committee on inpatient services, links to site issues and the uncertainty around these issues across the South West Cluster.

The Committee heard representations from two registered speakers:

Mr Richard McIvor of LINk addressed the Committee; in particular he made the following points:

• That  changes needed to be made to mental health service provision, but asked that patients and carers be fully engaged in the planning process regarding the future of services in the Borough.
• Concern was expressed that operational changes had and continued to be made, such as ward closures, before new community based services were in place.  This he claimed had resulted in some people not receiving the care they needed.
• That carers should feature more highly in the development of new services

Mrs Kathy Sheldon of Friends of Barnes Hospital addressed the Committee; in particular she made the following points:

• That care should be patient centred and that this was not evident at present.  Decisions were being made without the involvement of service users.
• That the creation of a Memory Clinic was welcomed but that more would be needed around the Borough, similarly this was the case with day care centres such as Ham.
• That it was important to protect the highly skilled mental health workers currently within the Community Mental Health Teams from leaving the Borough when the CMHT’s were disbanded.
• That it was important to keep services currently in place until, if necessary, they were replaced by other services.
• That the report before the committee was welcomed.

Sue Denby, Kingston and Richmond Service Director and Kim Goddard, Director of Nursing and Operations, both of South West London and St George’s Mental Health Trust attended to present the report to the Committee.  On introducing the information therein they referred in particular to the following:

(i)      That it was regrettable that they had not been able to attend the normal meeting of the Committee in September and that they were grateful that the special meeting had been called in order to give them the opportunity to update committee members.

(ii)    That this report followed on from the update that Sue Denby and Judy Wilson had provided for the Committee in January 2011 about the implementation of NHS Richmond commissioning intentions for the older people’s inpatient service and home treatment provision. This report would particularly address the current position and concerns about:

·         Services at Barnes Hospital and the outcomes of the two recent stakeholder meetings held there on the future of the site.

·         Section 136 and intensive care services at Tolworth Hospital as these were also provided for Richmond residents.

·         Commissioning intentions for single sex inpatient provision.

·         The progress of the Foundation Trust consultation exercise.

(iii)   That work relating to the provision of intensive home care services the Borough continued to follow the Sutton model which had been shown  ...  view the full minutes text for item 98.