Agenda item

To receive an overview of Community Mental Health Services in Wokingham.

The Committee received an overview of the Community Mental Health Services in Wokingham from Christine Dale, Assistant Director Integrated Mental Health, WBC, and Head of Mental Health, BHFT, and Helen Williamson, Operational Director Mental Health, BHFT.

During the discussion of this item, the following points were made:

·       Christine Dale explained that she managed the following services –

Ø  Community Mental Health Team (adults)

Ø  Memory Clinic

Ø  Community Mental Health Team (Older Adults)

Ø  Home Treatment Team (Older Adults)

Ø  Recovery College

·       Berkshire Healthcare NHS Foundation provided 40 Mental Health Services.  These included local community-based services, specialist services, hospital based service, and Berkshire wide services.

·       Christine Dale provided more information on the Community Mental Health Team (Adults).  The service was fully integrated between health and social care.  Staff included medical staff, social workers, nurses, Occupational Therapists, and support staff.  All referrals came through a common point of entry.  The team dealt with adults with a severe and enduring mental health need.  There were single integrated processes under the joint management.

·       Within the Community Mental Health team there was a psychological service.  There was also a Carers Worker who could undertake carers’ assessments, and assessments under the Care Act for funded care packages.  Work was carried out with the ICB to jointly fund packages where people were entitled to health and social care support as a jointly funded care package.

·       Accreditation with the Royal College of Psychiatry had been recently achieved for a further 3 years.

·       Talking Therapies provided treatment for common mental health problems e.g., depression, stress, anxiety, or phobias.  Christine Dale outlined how this service was delivered, such as workshop, videos, and guided self-help.

•        The Crisis Resolution Home Treatment Team offered a 24/7 immediate risk triage assessment by the duty team.  It had suffered no reduction in service during the pandemic and the workforce had remained consistent.  However, drug and alcohol cases had increased during the pandemic, as had the complexity of cases and psychotic presentations.  One of the issues for the team during the pandemic had been a fear of job losses following the introduction of mandatory covid vaccinations for health staff.  Reduced capacity of other services had also increased workload.

·       Members were informed of the Psychological Medicine Services.  Since March 2022 the team had operated at full pre pandemic levels.  However, the demand for psychiatric beds remained above the expected norm, although this was similar to the national picture.

·       The Recovery College, developed in 2020, was a prevention service open to residents and staff over 18 plus.  Co-produced courses focused on improving mental health and wellbeing.  The college aimed to help people become experts in their own self-care and enable family, friends, and staff to better understand mental health.  The service had been shut down because of Covid and had moved online during the pandemic.  A hybrid approach was now offered.

·       The Mental Health Integrated Community Service (MHICS) offered an integrated primary-care service to individuals who suffered from significant mental health needs and which were too complex for primary care services (such as IAPT) or they did not quite fit the criteria for secondary care pathways.  Already running in Reading, this service was due to be rolled out in Wokingham and was being recruited to.

·       The impact of Covid and access to services included the following -

Ø  Remote Working during Covid using video consultation, phone contact and face to face when clinically appropriate

Ø  Memory Clinic was only serviced ceased for first wave only

Ø  Some staff shielding accommodated

Ø  Control of environment for Social Distancing etc.

Ø  PPE used

Ø  Staff prioritised for vaccines

Ø  Rise in numbers with psychotic illness first wave

Ø  Rise in referrals for depression & anxiety due to isolation, job loss, bereavements, physical health etc.

Ø  Evidence of some people declining to be seen

·       With regards to workforce and the impact of Covid, the peak of Covid Omicron infection had impacted most between January- April 2022.  Some redeployment of WBC staff had been required to support services most affected by Covid sickness absence during this period.  Covid still remained a high cause of staff absence.

·       Members were encouraged to look at the list of different services and ascertain if there were any areas that the Committee should look into further.

·       With regards to the Crisis Resolution Home Treatment Team, a Member questioned whether anyone could access this service even if they had not been in crisis before.  Helen Williamson confirmed that it was.  In addition, those on the waiting lists for services were encouraged to use the service as a way of managing alternative arrangements whilst they waited to be seen.  In addition, NHS 111 could redirect people to the crisis service.

·       Members questioned whether the level of referrals had returned to pre pandemic levels.  Helen Williamson commented that it was an ongoing process.  Whilst it had increased to some extent, levels were still not at previously anticipated levels. 

·       A Member questioned whether the anticipated surge in demand post Covid had been as great as originally anticipated.  Helen Williamson commented that a peak had likely been seen, but that services were planning for another surge of Covid, and also for pressures caused by flu season.  Services were very stretched, and demand was increasing.

·       In response to a Member question, Christine Dale clarified that SI were Serious Incidents, such as suicides, for which there was a formal investigation process.

·       A Member questioned whether further support with communications was required.  Helen Williamson indicated that there was some communications support resource in place, but any additional support would be welcome.

RESOLVED:  That the overview on Community Mental Health Services in Wokingham be noted, and Christine Dale and Helen Williamson be thanked for their presentation.