Healthwatch Representatives Feedback Form

Martin Haddon Representative name Lauren Ashley-Boyall

Meeting with CCG/JCU to discuss mental Meeting health commissioning and arrangements for public engagement

1!2 June 2014 Date & Time 11am

Mark Robertson, Joint Commissioning Who attended Manager for mental health and learning disability Mark kindly accepted our request to Key issues discuss the commissioning process and the arrangements for engagement with service users, carers and the public. Main points are below:

5-year strategic framework: the Wandsworth Mental Health Joint Commissioning Plan which had been the subject of a public engagement event in January had now been approved by the JC Executive and will be submitted to the Health and Wellbeing Board on 24 June. We welcomed the inclusion of a detailed feedback report from the engagement event. Mark confirmed that the Plan once approved would be published on the CCG or JCU website and there would be further public engagement in due course as strategic planning was ongoing.

The plan dovetailed with the draft 5 year strategy published on 30 May by South West London Collaborative Commissioning and both were based on the latest central NHS guidance. SWLCC are making their own arrangements for patient and public engagement.

We pointed out that the Wandsworth plan contained a strong commitment to put engagement with service users and patients at the centre of the commissioning process – but that the relevant wording in this part of the Plan made no mention of carers, families or the wider public. Mark said the wording had been carried over from a basic JCU document but that he would take this point back to the Unit for further consideration. It was acknowledged that that Carers and Families were included substantively throughout the Plan, notwithstanding the JCU section referred to above.

Annual commissioning process with SWL & St George’s Mental Health Trust: This proceeded in parallel at both the South West London (“cluster”) level – for which Kingston CCG took the lead- and at local Wandsworth level. There would be a single contract for 2014-5 with service levels agreed at cluster level but with detailed variations for the individual boroughs.

The boroughs were also much involved in identifying efficiency savings under the CIP (Cost Improvement Programme – an annual 4% saving required centrally after allowance made for inflation) and the QUIPP (Quality, Innovation and Productivity Programme).

Some of these efficiency savings would be delivered under the Trust’s broad Transformation programmes (such as those already identified for the Acute Care Pathway and still under negotiation locally for Community Services) – the Trust was responsible for ensuring the necessary consultation on the CIP/Transformation programmes. Other savings were negotiated locally piecemeal such as the replacement of the Wandsworth Arts Therapies service by alternative non-verbal therapeutic activities which would be less resource- intensive. Further savings continued to be explored in conjunction with the Trust (as part of CIP), through the MH CRG including opportunities for greater productivity withinwere also being looked for from the newly established Community Rehabilitation provision. Service pending agreement on the wider Community Services transformation programme. We suggested that the impact of further savings on the rehab service would need to be carefully monitored.

The outcome of the commissioning process would be reported to the CCG Board meeting in July which would be focussing on mental health. Mark undertook to consider the question of subsequent publication.

Role of Clinical Reference Group: the Mental Health CRG, which is effectively a decision-making body subordinate to the CCG Board, has a number of service user and carer representatives whose role is to feed in users and carers’ point of view. Mark confirmed that he is actively working on the publication of the CRG minutes as requested by Healthwatch. Publication is likely to extend back to 2013. This will help Healthwatch and others keep track of the important work of the CRG and give earlier warning of issues.

Mark confirmed that the work of the CRG’s subgroup on problems of BME mental health will continue to be shared with the BME MH forum. The CRG’s review of IAPT services (which is potentially of interest to a significant proportion of the population) has so far focussed on ways of improving performance against existing targets including waiting time targets. Longer term Ooptions for more substantial changes continue to be explored through the MH CRG have been identified butand there would need to be appropriate engagement & consultation before taking any of these further. We will follow progress through our Healthwatch Actions attendance at the CCG and Health and Wellbeing Boards.

The Meeting in one A useful exploration of the mental health sentence (for blog, FB, commissioning process and the Tweeter, newsletter) arrangement for public engagement.