Agenda item

Presentation from Jacqui Van Rossum - Executive Director Integrated Care London & Integration and Dr Steve Feast - Executive Medical Director.

The Chairman welcomed Dr Steve Feast, Jacqui Van Rossum, Dr Afifa Qazi and Caroline O’Donnell from the North East London Foundation Trust (NELFT). Members of the Board were asked to note the following:

The Trust had been through many changes, originally a mental health trust, (NELFT) now provided mental and community health services for Waltham Forest, Redbridge, Barking and Dagenham, South West Essex and Havering.

The area of North East London increasingly presented many challenges and the NELFT team welcomed the opportunity to engage with the Health and Wellbeing Board acknowledging the importance of holding cross borough dialogue and working together.

New relationships were being built with the Integrated Care Coalition, Urgent Care Coalition and the provision of community mental health services to Barking Havering Redbridge University Trust and Barts Health. The changes within the NHS and the inspection regime made for challenging times ahead.

Following the Francis Report, NELFT staff were on 7 day working, however, the Trust needed to recruit more staff and were finding it difficult competing with the inner London Trusts. In response to the Francis Report, a number of initiatives were organised including the setting up of communication campaigns, conferences, focus groups and the promotion of relevant policies. Whistleblowing was also available as a last but open resort.  NELFT had doubled their focus on quality and moved to borough based quality care. 

  In past years, mental health services had been transformed following the closure of asylums. In addition, there had been a change in approach to medication use and consolidation of community beds into a single high quality unit.  A similar pattern had been seen in the care of the frail elderly although it was noted that these patients often have very complex drug regimes. The model on which only 3% of mental health patients attend an inpatient unit needed to be replicated with the frail elderly. 

Members were informed that Havering’s award winning service in dementia care had resulted in zero acute admissions for two years.  As a result, wards had been closed and funds moved into the community. RAID (Rapid Assessment Interface and Discharge) teams had also saved 2,600 bed days resulting in £1.4M in savings. There were now 2200 staff in partner hospitals who had received training in working with people with mental illness in addition to a  24/7 helpline. 

There are now close links with GPs/practice nurses, care homes and Community Mental Health Teams with a consultant mobile number available, same day responses, clinic emergency slots for patients in crisis and contact with all patients who fail to attend clinic appointments. Patients are also encouraged to call the clinic if there are any problems. Stimulation therapy is also available as well as Reminiscence therapy. As a result, care home admissions have dropped. 

Average waiting times have been reduced for Memory clinics,   Havering has a three week waiting list which compared to the national average is very positive. With regards to acute services, Havering has a new facility at Sunflowers Court and the number of acute admissions has fallen owing to the development of home treatment.  

The Community Care Treatment Team was launched in April 2013 and was working with the CCGs, Queens Hospital and the A&E interface as well as the ICC resulting in a 14% reduction in admissions into acute services. The savings in funding has been returned to the Commissioners.

NELFT acknowledged that winter was a challenging period and that contingency plans were in place. 

The Chairman thanked the NELFT team for their presentation. It was agreed that it was useful to know that any concerns about services in Havering could be discussed with the Managing Director of Community Services responsible for area. Members of the Board underlined the need to ensure that people in Havering were getting the best care and that mental health services required further development. It was agreed that there was further to work to do in developing projects around prevention linking in with Public Health and the CCG.