Hardwick Clinical Commissioning Group
DRAFT Notes
Coordinating Group Mental Health Service Receiver and Carer Engagement Service
Thursday 26 October 2017 1.45-3.45pm Strutts Centre, Belper
Attendees:
Commissioning Representation: / Claire Burnage, Hardwick CCG, Contract Lead, ChairDavid Gardner, Hardwick CCG and STP Programme Lead
Tracy Lee, Southern Derbyshire CCG and STP Programme Lead
Sue Whetton, Derbyshire County Council, Commissioning Manager for Mental Health and Older People
Partners: / Karen Ritchie, Chief Executive, Healthwatch
Jenny Appleby, Derby City Council, Strategic Commissioning and Partnerships Manager
Niki Glazier, Engagement Officer, Healthwatch
Darren Greenwood, Engagement Officer, Healthwatch
Daryl Thompson, DHcFT, Deputy Director of Nursing and Quality
Angela Kerry, DMHF, Manager
Service Receivers and Carers: / Helen Cochrane, N Derbyshire MH Carers Forum
Sue Wheatcroft, BPD Support Group
Apologies: Patrick Murphy, DCHS, Strategic and Clinical Lead Older Peoples Mental Health
Jenny Appleby, Derby City Council, Strategic Commissioning and Partnerships Manager
Katrina Herrod, Hardwick CCG, Clinical Quality Officer
Helen Henderson-Spoors, Intelligence and Insight Manager, Healthwatch
Carolyn Green, DHcFT, Executive Director of Nursing and Patient Experience
Phil Sugden, HCCG, Assistant Director of Quality
Roger Kerry, NDVA, Mental Health Liaison Officer
Sandra Austin, Carer representative
1.Welcome and Introductions
Introductions were made and confirmed that the group was quorate.
The service has agreed a name of Mental Health TogetherFor Derby and Derbyshire.
Claire offered condolence on behalf of the group as sadly, since the last meeting, Jonathan Norton had passed away. Jonathan has been involved in patient engagement for many years and had been attending the coordinating group as a service receiver. His honest views and input were greatly appreciated.
2.Declarations of Interest
The CCG’s have been advised by auditors that declarations of interest should be a standing agenda item on all meetings. There were no declarations of interest.
3.Matters Arising
There were no matters arising from the previous notes. AOB was raised as IAPT event, Training and Mental Health Together report.
4.Notes of the previous meeting 27 July 2017
The group agreed that the notes were a true record.
Claire – glossary to be created – paper copies were circulated and will in future be circulated with agenda’s and updated with new Acronyms as they are highlighted.
5.Terms of reference
The Terms of Reference had been amended to reflect the discussion at the last meeting. As agreed they had been shared with Mental Health Together and Angela Kerry, who agreed them.
Terms of Reference were ratified by the Coordinating Group.
6.STP Healthwatch Link Workers
These were confirmed as:
Responsive Communities: Niki Glazier
Dementia and Delirium: Darren Greenwood
Primary Care: Claire Reece
Rehab and Forensic Pathways: All engagement officers but with Darren as first point of contact
Tracy Lee confirmed that initially it had been reported that there would be a project board for each workstream. It has now been decided to have just the 1 project board as many things overlap and there would then potentially be subgroups created for particular pieces of work.
7. Managing the distribution.
A few people have asked to be on the list. The distribution list had been agreed previously that there would be a point of contact at each partner organisation who would then cascade theinformation to relevant colleagues. Claire was mindful of this although did understand the rationale for the requests being made. Claire has started a ccin via a separate list, and any ideas and issues requested. Sue Whetton suggested that it would be useful to look at the list.
Angela Kerry suggested trying other days for meetings so people who work different days would be able to attend. Claire Burnage stated that Thursday and Friday afternoons was the original request made by Derbyshire Mental Health Alliance, but now this meeting would involve other service receivers, alternating the days for the meetings should not be a problem.
Helen Cochrane suggested that afternoons are better for people who use services
8.Setting the priorities
High Peak Neighbourhood (raised by DHcFT). Discussed the initiative suggested by Ellie Brett, Lead Nurse and Carers Champion, around supporting service users to contribute to service developments in the High Peak. AK suggested all agencies should work together, including CVS. Discussed the need to include the interface between Stepping Hill / Neighbourhood Teams / Crisis Team. Would need a clear plan to be developed by the group with end point. We need to scope out the time commitment, and some more detail. Would be useful from an engagement point of view, to get a snapshot view of the services, to start to look at the issues in that area. Karen Ritchie suggested that it would be useful to focus on one area, rather than on Derbyshire as a whole. Tracy Lee suggested trialling it in the city as well to compare. General discussion of the challenges of 111 staff thatmight not have local knowledge of mental health services.
Action: Daryl Thompson to share questions with Darren Greenwood. Darren to meet with Ellie. Develop a template outlining the proposal/ timelinesaims / objectives / likely cost / on-going time commitments / who else is involved. This can then be used for future proposals. It needs to include social care as partner, and experiences of moving between services (inpatient / community).
Suggested Holly Martin, Liaison Social Worker for Stepping Hill could be involved around Stepping Hill.
Resource and Signposting (raised by Erewash MH Pathway meeting and also the Mental Health Together Steering Group). Karen Ritchie – this issue has come from general conversations but was raised at this, about how people access information and know about this. Why are people having problems, why don’t they know what to go, what would make it easier? Is this a problem in all areas? Mental Health Togetherwould be prepared to look at this in one particular area. Dave Gardnerstated that now that the organisations know about each other, what would help? Need to plan for something doable, as people don’t have capacity for anything more. Angela Kerry suggested that even though everyone was around the table, they weren’t necessarily sharing this with colleagues in their own profession or area. Dave Gardner has noted that the waiting list in the neighbourhood team at Erewash has dropped below 18 weeks, and this initiative could be part of this effect. Mental Health Together can do this piece of work with Erewash CCG, but Karen Ritchie is also thinking that her team do general engagement anyway, and these are simple questions that could be asked as part of this. The group agreed that this would be a really helpful way of scoping this issue, to link the network of service receivers through to the mental health pathway meeting. Angela Kerry reaffirmed that the focus is on the experience of the person going through this.
Action: Mental Health Together to add some general questions to questions already asked during its general engagement that could identify themes that could then be picked up as specific pieces of work.
MH accommodation and support strategy (A&SS)(raised by Derbyshire County Council. Sue Whetton explained that the STP workstream has thrown up issues around housing and also with the homelessness act and welfare reform, felt this is a good time to develop a strategy. Dave Gardner suggested that regarding STP that it might be helpful to have a closed group rather than asking lots of people to come to meetings. Sue Whetton at this time wanted to flag up that this piece of work has been started which also includes forensic, autism, Asperger’s and people with complex needs. There has only been one meeting of the A&SS and will now be called Specialist Accommodation and Support Strategy as it covers more than mental health. Mental Health Together will be approached to get involved if interested, perhaps looking at what are the cohort of people and their housing needs.
Karen Ritchie asked if Mental Health Together could be given advanced notice of requirements.
Action: Sue Whetton to advise Mental Health Together about future meetings. An engagement officer could attend in the first instance to consider how best to engage.
Autism (raised by Mental Health Together Steering Group) Karen Ritchie stated that many people have got concerns about support they get after autism diagnosis and the waiting times. They wondered what the Autism pathway is in Derbyshire and if this is the right time to do some engagement?
Sue Whetton gave an update on Autism. There is a strategy that is about to be ratified. Jen Stothard at Hardwick CCG has done lots of work on the diagnostic pathway, and the next priority is post diagnostic support. There is a service user rep on this group, the Autism Board.
Angela Kerry suggested that maybe the time to influence things has gone, if the first time we hear about these things is at this moment. Sue Wheatcroft asked if the parents of people with autism are being considered. Sue Whetton wondered if this would be part of the diagnostic pathway.
Discussed knowledge of and helpfulness of counselling services, more self-help opportunities e.g. IAPTand the potential gap between IAPT and DHCFT. Dave Gardner also mentioned that telephone support can be a challenge for people with autism.
Action: Engagement officers to link in with Deborah Jenkinson at Derbyshire County Council and Jen Stothard at Hardwick CCG. An invitation will be sent for Deb or Jen to attend a Mental Health Together Steering Group to give an overview.
Staying well (raised by Mental Help Together Steering Group)A number of issues that have been put into this category, about people accessing services to avoid relapse and crisis, recovery education, access to support. Tracy Lee agreed that these are common threads. Sue Wheatcrofthighlighted the importance of being referred to the right service in the first instance. Sue Whetton asked if we can make sure people know about the recovery peer support service. Dave Gardner agreed that an STP lead could attend a Mental Health Together Steering Group to discuss this and infact it would be helpful for the STP leads to attend those meetings at intervals to provide an update.
Action:All ofthese things are part of the MH STP Workstreams, and the STP will contact the engagement officers when a piece of work is identified requiring the Mental Health Together service input.
Personality disorder pathway (raised by the Steering Group)Sue Wheatcroft has been asking people who have been sectioned and their support workers, on personality disorder overall, what kind of things would prevent them from falling into crisis again on being discharged from the unit. The group suggested we also need to be asking what would prevent them from being admitted in the first place. Sue Wheatcroft state that patients wait a long time to see a psychiatrist, feel that they diagnose, medicate and then see in three months. A lot is expected of the appointment but crisis can come afterwards, healthcare staff are not trusted. 1 in 10 PD sufferers commit suicide through frustration, stigma and not getting help. PD suffererswould appreciate a buddy system, perhaps by phone, someone who has been through the system and can be trusted. Dave Gardner stated that there has been discussion around personality disorder and the STP has agreed in principle to invest in personality disorder. A group will need to formed to coproduce how we work out what commissioners need to invest in.
Action: STP will pick up the PD requirements and contact Mental Health Together when applicable. Sue Whetton and Sue Wheatcroft to discuss this further, outside of this meeting. Sue Whetton to pick this up with the Recovery and Peer Support Service around incorporating this into the telephone line.
Psychological Therapies (raised by STP Primary Care and Mental Health Together) There was not enough time to discuss this but Tracy Lee had previously met with Karen Ritchie to discuss the requirements of Mental Health Together when looking at this area of work under STP. In addition, Karen has also met with Gemma Ashby, Hardwick CCG to discuss in more detail Mental Health Together’s help with some engagement with hard to reach groups not accessing the IAPT services. As this had been agreed at the last meeting the group agreed for Karen to go ahead with this piece of work.
9.STP Update
There was not enough time to receive an overview of STP, but the work that is happening has been touched on during the meeting. Kate Majid, who was the lead for Community Resilience has now left the NHS so this has slowed the work in this area.
10.Any other Business
TrainingKaren Ritchie has been in touch with the Consultation Institutein respect of coproduction training. This can be paid for from the Mental Health Together budget, 20 places for commissioners, in particular the STP leads and coordinating group members.
Subsequent training will also be offered to service receivers and carers actively involved with MHT. .
The second stage of the training would then be to take the useful aspects of the above plus the Healthwatch aspects of coproduction and present a short (2hour) coproduction training session (delivered by Mental Health Together) at the start of any piece of work. This way the training will be cascaded. By having service receivers present it was felt that they could give good and bad examples of coproduction.
Mental Health Together report Karen Ritchie had produced a report highlighting the work undertaken so far by Mental Health Together. This will be circulated with the minutes. Areas highlighted were Ward Visits: an agreement had been reached with LG Consultancy (Lynn Gibson) to undertake the ward visits every 3 weeks. Lynn Gibson has been asked to include further questions such as what would have stopped admission and what do you need now. More outcomes were expected by giving feedback to DHcFT and will be asking DHcFT for its feedback on lessons learned from the ward visit report. During January – March 2018 ward visits will take place in other locations and new reps will be trained. Dave Gardner did raise some concerns around Stepping Hill and that we have a small number of patients there. Karen Ritchie confirmed that they would be included in the ward visits. Helen Cochrane suggested that carers could also be involved in being questioned during the ward visits.
Action: Karen Ritchie to share the current questions with DaveGardner/Sue Whetton and Angela Kerry. Suggest Karen Ritchie also contact Joe Wileman at the DHcFT.
Derby City Recovery Hub Karen Ritchie informed the group that Mental Health Together assisted commissioners to host an event in the city around the mental health services there. 47 people attended, all of whom said that they had found the event useful.
Action: Karen Ritchie would like Derby City Council to feedback about what has happened as a result of the engagement. Karen to contact Jenny Appleby.
Engagement requests inbetween Coordinating Group meetings Karen Ritchie asked what happened to requests for assistance inbetween the coordinating group as it was not expected to meet regularly. Dave Gardner confirmed that the general direction had been set by this group. STP was a priority for the commissioners and the STP leads could discuss pieces of work with the engagement leads. For other things it would be dependent on if Mental Health Together had capacity and if it saw the piece of work as relevant/strategic etc.
The group was not here to review every single request but act as a conduit and assist Mental Health Together in deciding what work to prioritise as more requests are received.
Some things can be done ’virtually’ without the need for a meeting.
11.Date of next meeting To be confirmed.
Action: Mental Health Together to confirm to Claire Burnage the 2018 Steering Group dates. Claire will then send out diary invitations to the Coordinating Group. Claire to cancel the 1 December meeting date provisionally held in diaries. This will give Mental Health Together time to work on agreed topics and the STP time to identify its priorities.
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