To receive a report from Enfield Clinical Commissioning Group, on the outcomes from the recently completed Barnet, Enfield and Haringey Sustainability Review. 

The Board received the report from the Enfield Clinical Commissioning Group (CCG) on the outcomes from the recently completed Barnet, Enfield and Haringey Mental Health Services Sustainability Review. 

1.               Mental Health Sustainability Review

Paul Jenkins, CCG Chief Officer presented the report to the Board highlighting the following: 

·       The purpose of the review was to find ways to achieve sustainability across the Mental Health Trust, considering both the opportunities and challenges it faces. 

·       The review was an external review carried out by Carnall-Farrar, and sponsored by the Trust Development Authority.  It considered the quality of the services provided, the outcomes required as well as mechanisms for delivery. 

·       The recommendations are now with the Barnet, Enfield and Haringey NHS Trust.  The review was supportive of the Trust and the Trust was pleased that it showed shared values and an understanding of the challenges faced.

·       The review judgements on quality and outputs were positive, in comparison with similar trusts in London, and they will provide opportunities for both the commissioners and the trust to improve what they do and for the transformation of services.  The full report can be made available on request.

·       Areas for improvement include improving the infrastructure – maximising the use of the estate - and making clear changes in the models of care provided, as well as reducing length of stay.  As with similar trusts, there is a need to work leaner, smarter and more efficiently. 

·       It is necessary to understand what is causing the deficit and provide redress linked to the wider transformation programme recognising recognition that efficiencies need to be resolved.

·       The interim agency workforce is another area to be addressed.

·       Working out how improvements can be carried out will take place over the next few months, working with the regulator, the three boroughs and the three clinical commissioning groups.  A more structured action plan is proposed.  Enfield will help to facilitate this.

·       This is an opportunity for the trust, not just about the finances but about improving quality, responsiveness and outcomes, working on behalf of patients and residents.

2.               Questions/Comments

2.1           Andrew Wright, on behalf of the Mental Health Trust, advised members that he welcomed the positives from the review and the support of his commissioning colleagues.  The positives including on performance, staff and most significantly on the long term sustainability of the trust as it exists at present.  The potential that the trust might have had to merge with another trust was very unsettling and unhelpful.  Now it will be possible to work with the commissioners on the longer term sustainability and to address the underlying funding issues. 

2.2           Deborah Fowler asked to be sent copies of the full reports.

2.3           Enfield and the other local authorities have been fully engaged with the review, our Chief Executive was interviewed and Enfield was part of the feedback.

2.4           The review removes some of the speculation and rumour that has been circulating around the future of the trust. 

2.5           The work on improving the trust will be carried out in collaboration with the North Central London boroughs and will include the Tavistock Institute.  Mental health is a key area for the North Central London boroughs and the intention is to include Camden and Islington. Although these boroughs have different financial circumstances they all face similar challenges.  All will be involved in preliminary discussions. 

AGREED to note that over the next 6 months, each of the recommended actions will be scoped and a more detailed programme plan developed, with the programme structure and resources put in place.  A full stakeholder engagement and communications plan will be developed to ensure that staff, external stakeholders and patients are engaged and kept informed as this important work progresses.