Agenda item

To receive the report of the Executive Director – People, to provide an in-depth review of the Mental Health Transformation and what this means for local services and Enfield residents. This includes an outline of the approach to supporting young people in mental health crisis following Covid.

RECEIVED the report ‘North Central London (NCL) Mental Health Transformation and Childrens & Young Persons Mental Health Crisis Response Update’ and attached presentation.

Officers thanked the Panel for inviting them back after a year in respect of the transformation of mental health services across Enfield. The Community Transformation Programme was summarised in a Youtube.com animation which was linked on page 14 of the agenda pack and played to the meeting.

Questions were invited from Members.

In response to Members’ queries regarding autism and ADHD waiting times, it was advised that significant waiting times were a national problem, but work continued to reduce these and to have access to care as quickly as possible.

It was clarified that the holistic assessment function related to ‘telling once’, in response to patients’ concerns of having to repeat their story multiple times.

A transition service for 18 to 25 year olds would support those making the transition from children’s to adults’ services.

In response to queries regarding funding and access across North Central London, it was confirmed that NCL ICB had met its mental health investment standard and had given Enfield additional funding over the baseline in recognition of inequalities and service gaps, and continued investment would ensure delivery in line with the offer. There was recognition that the pathway to services could be difficult. Not everyone went to a GP for referral to CAMHS so there was support in schools and work towards coverage in all schools. It was confirmed that presentation at A&E referred to Barnet as well as North Mid. There were also walk in clinics in libraries and surgeries where a young person could go without a referral. There was currently work with Jubilee Church in respect of providing walk in clinics. Improved communication was being worked on with stakeholders about how to access those services. The engagement and governance structure ensured information was shared on a regular basis.

In response to Members’ queries regarding adults in mental health crisis, it was confirmed there were liaison services in all Enfield’s acute hospitals; a mental health crisis centre in Highgate; and a 111 call option. With transformation funding, services were being invested in such as crisis cafes.

It was advised that monitoring was done with a sophisticated management system for caseloads. Managers could monitor when a client was last seen, or should have been reallocated, etc. to supervise the service and quality.

More information was also provided in respect of performance, and that an assessment had to have the user at its centre, the care plan must be agreed with the user, and a treatment plan should be started within four weeks.

It was confirmed that following initial assessment of needs, there were four teams which specialised in different treatments, some clinical and some more emotional. At the point of entry there was a determination and allocation to the right place for needs to be best met.

Members asked about what could be done about external factors which could impact mental health. It was advised that officers could for example support clients to keep their tenancy and support them in accommodation, and work was done with the Housing Department and local authority in creative ways. There was also support to keep clients in employment, and enabling people to connect with voluntary sector organisations like MIND. Collaboration with the ICB included homelessness teams coming into hospital wards, and employment services co-located with crisis teams.

The Director of Adult Social Care advised that people wanted a single point of contact, a place to go where someone would listen, and help to navigate the system. It was also acknowledged there was good non medical work done by the third sector, and the Council sought a longer term view in awarding contracts to increase certainty for them.

In response to queries around increased mental health funding, it was advised that the metrics for investment were around case findings and contact, which was increasing by 5% year on year. NCL ICB had met the investment standard and maintained its baseline. Resources were monitored by the ICS Programme Board which met monthly.

In response to Members’ concern that 19% of calls to the hub were unanswered, it was clarified this related to a professional line for advice and guidance to the Metropolitan Police. There had been some issues with its roll out but it was aimed for 100% of calls to come through or receive a call back, to ensure that patients went to the right place for their needs.

The Chair thanked all attendees for providing the update and answering Members’ questions.