Primary Care Commissioning Committee 14 December 2016

Date
Wednesday 14 December 2016
Time
1:00pm - 3:00pm
Venue
The Board Room, Leafield House, NHS Leeds North CCG
CCG
Leeds North CCG

From 1 April 2016, NHS England has delegated to the CCG authority for commissioning primary medical care in Leeds North. To make decisions on the review, planning and procurement of these services, the CCG has established a Primary Care Commissioning Committee.

Members of the public are welcome to attend meetings, which will be held from 1.00 – 3.00pm at  the CCG’s offices at Leafield House. (Directions to Leafield House and parking.) Details of the papers and minutes for these meetings can be found here, and previous meeting papers can be found in the publications section.

At the start of the meeting we welcome questions from members of the public, regarding agenda items.  Due to time limitations, we will give priority to questions submitted in advance. Should you wish to submit a question, please email: leedsnorthccg@nhs.net with PCCC Question’ in the subject heading, or call the CCG on 0113 843 2900.

Questions from the Public at the 14th December meeting.

The PCCC received the following written questions in advance of the meeting:
Can the PCCC provide an update on the implementation of the Mental Health Liaison pilot, including the duration of the pilot, the names of the GP surgeries hosting a mental health liaison worker, the evaluation framework and the process the CCG will use for deciding whether to continue the pilot or not? Chapeltown Mental Health Wrap-Around Support

Mental Health was raised by Chapeltown GPs as a priority area where a new way of working was needed to address and support people with identified or unidentified mental health needs. This included patients who had mental health needs but were not appropriate for treatment in Increasing Access to Physiological Therapies Service (IAPT) and patients who were diagnosed with serious mental illness such as schizophrenia, bipolar or other affective disorders. The data showed that there are a significantly higher number than average of patients in these groups within the locality.  The new model of care test project in Chapeltown was developed to deliver mental health wrap-around support for these patients.

The local GPs felt that many people with mental health needs were ‘bouncing’ between services because the system wasn’t spending time to support an early assessment to understand their individual circumstances then support access to the most effective service if and where those services are available.  The other aim the GPs had was to support both physical and mental health needs in a holistic way, and improve the whole flow of how patients move around the health and care system, re-balancing where some of the care is happening to better meet both physical and mental health need. For example, many patients once diagnosed with a mental health condition can get stuck in a service even though they are stable and don’t require the same level of support.

The CCG has supported a model which will be delivered for 18 months from October 2016. The multidisciplinary team includes Mental Health Liaison Workers and Emotional Support Workers who are practitioners with mental health and psychological expertise, who work alongside practices to provide assessment, liaison and early intervention. The aim of the Mental Health wrap-around team is to support the work of general practice, provide emotional support within a primary care setting to patients, provide assessment and referral on to other services where needed, liaise with secondary care mental health services and follow up patients with serious mental illness who have been discharged back to primary care.

It is envisaged that this additional support will enable the move of some patients who are stable and receiving services from the specialist mental health team at Leeds and York Partnership NHS Foundation Trust (LYPFT) back under the management of general practice where patients can have their needs met in a holistic way.  But likewise where patients may have been discharged back to primary care inappropriately patients can be directed back to specialist care.

The GP practices working within the care model are; St Martins Practice; Newton Surgery; Westfield Surgery; Chapeltown Family Surgery; Woodhouse Surgery.   The model will be delivered from and across all these practices as a local area serving the population. The Light Surgery is aligned to this team but is looking at a more focused mental health model to meet their specific population’s needs.

The test project is using the agreed Community Based Mental Health Model design proposal and will be focusing on the patient and system impact to prove effectiveness.   The test project is overseen by the Mental Health Framework Programme Board , the learning will inform the future commissioning and re-alignment of resources to scale the type of model if proven successful.

The following verbal supplementary questions were also asked at the meeting:
Please could you give further clarification, specifically on the role of Mental Health Liaison Workers and what they will do? The Liaison and Emotional Support Workers will be able to undertake initial assessments in a primary care setting.  They will see patients  for short term interventions where they may not be suitable for other services, and work with patients where they  have a combined physical and mental health need and will work with patients, carers and professionals  to ensure patients get to the appropriate service and avoid duplicating investigations and monitoring.
Is it a resource for GPs to be able to refer to before or instead of referring patients to IAPT? (Improving Access to Psychological Therapies)? In some cases, yes.  Many people being helped by the Mental Health Wrap-around team are patients who would not be considered appropriate for referral to the Increasing Access to Physiological Therapies Service (IAPT) for IAPT or Community Mental Health services but still have a requirement for some level of support. That said GPs will still always make referrals based on clinical need and will refer to IAPT or Community Mental Health services where appropriate.