Working together to improve mental health A Partnership Board made up of representation from the Local Authorities and NHS Trusts

CUMBRIA AND LANCASHIRE STRATEGIC HEALTH AUTHORITY • WITH PCT & PCT • FYLDE PCT • PRESTON PCT • LANCASHIRE COUNTY COUNCIL • , PENDLE & ROSSENDALE PCT • BOROUGH COUNCIL • BOROUGH COUNCIL WYRE PCT • BLACKPOOL PCT • WEST LANCASHIRE PCT • & PCT • LANCASHIRE CARE TRUST Foreword

The Lancashire Mental Health and Social Care Partnership has been established to lead and support a programme of change within Mental Health Services. We are determined to provide the people of Lancashire with modern and effective mental health services which are fit for purpose and focussed on supporting people to enjoy positive outcomes in their lives. We want services to be flexible and responsive to individual needs, underpinned by evidence of what works, which enable people to live the lives they want. We are committed to delivering changes that are now needed in collaboration with people who use services and their carers, the voluntary and independent sector and partner organisations.

Richard Jones Chair of the Lancashire Partnership Board, Director of Social Services, Lancashire County Council On behalf of the following members in the table below Vivien Aspey Blackburn with Darwen Primary Care Trust Chief Executive Pearse Butler and Lancashire Strategic Health Authority Chief Executive Judith Faux Chorley & South Ribble Primary Care Trust Chief Executive Julie Goulding Fylde Primary Care Trust Chief Executive Jan Hewitt Preston Primary Care Trust Chief Executive David Peat Burnley, Pendle & Rossendale Primary Care Trust Chief Executive (Co-Chair) Stephen Pullan Blackpool Borough Council Director of Social Services Finlay Robertson Lancashire Care NHS Trust Chief Executive Stephen Sloss Blackburn with Darwen Borough Council Director of Social Services Doug Soper Wyre Primary Care Trust Chief Executive Wendy Swift Blackpool Primary Care Trust Chief Executive Jane Thompson West Lancashire Primary Care Trust Chief Executive Mark Wilkinson Hyndburn & Ribble Valley Primary Care Trust Chief Executive The Case for Change A

The NHS and Local Authorities are committed to ensuring that good mental health and social care services are available for everyone and are working together to improve services.

This work will focus exclusively on Mental Health services and since treatment options available, other mental health and social care then each area has been planning than medication, and many people services for adults of working and the development of mental health are not sure where to go for help if older age living in East, Central and and social care services for adults they have social problems. West Lancashire and on the Fylde and older adults through Local Some progress has been made coast. It does not cover drug and Implementation Teams (LITs). LITs are to implement the National Service alcohol services, as there are comprised of people who use Framework for Mental Health, and different arrangements already in services, people who care for service new services are being put in place. place to plan for these (local Drug users, service providers (NHS Trusts, The emphasis has been on and Alcohol Action Teams). It does voluntary and independent sector) developing more community services not cover services for people living and those responsible for to support people in their own in Lancaster. Lancaster has been commissioning services (Local homes, but if services are going to excluded from this work because Authorities and NHS Primary Care improve, change needs to take place Bay Primary Care Trust is Trusts) on behalf of local people. across all services. We have been already consulting with the public on In the past there has been an over- working together to agree how we a set of proposals for improving reliance on hospital-based services are going to make services better. mental health services to the area. and insufficient use of other In 1999, the government published a agencies, such as voluntary National Service Framework for organisations. GPs have limited Our shared values

A number of key values have been identified which will underpin our future decision-making and change the way in which mental health and social care services will be provided in the future. These are:

• a commitment to helping • promote positive mental health • address the stigma and people with their recovery from and work with other agencies discrimination surrounding illness and/or the effects ill to tackle the causes of mental ill-health to ensure health has on their lives, mental ill-health people have equal access through services which work to opportunities to promote optimism and hope

Our shared vision for mental health and social care services

In order to modernise the full •Focus on services in the local • Better continuity of care. community, offering more choice range of services we are • Appropriate support is available for as close to home as possible. proposing that a number of the vast majority of people with important changes need to • Single access points into services common mental health and social take place, which are will make getting the right care problems in GP surgeries or other listed opposite: and treatment easier and quicker. community settings. • Access to support will be available to families and carers according to their individual needs. Our commitment to A improve services

Help with common mental Access to specialist mental Services for people in crisis health and social problems health and social care services For many years the only option At any time one in six people living in It is vital that there is a clear way of available to people who were very Lancashire will experience getting access to specialist services, distressed and at risk of harming depression, anxiety and phobias, where people can be seen quickly by themselves or other people, has otherwise known as common mental a mental health worker, who will been NHS hospital admission. health problems. Most of these discuss their problems and Consequently, the numbers of people problems can be resolved or treated recommend the best approaches to needing psychiatric hospital beds in by GP based services very help treat or resolve these problems. Lancashire has been high and in close to home. This discussion is known as many areas the hospital psychiatric an assessment. wards are of poor quality. It is At the moment there are some estimated that between 30 – 50% of services available from counsellors People should be able to get a the current admissions to hospital and GPs can prescribe drug specialist assessment at any time of could be prevented by extra support treatments, but choice is limited and the day or night, if they are in distress at home and in other types of there are not enough “talking” or have reached a crisis point temporary supported therapies and social support for the because of their problems. accommodation, such as, non-NHS people who need them. There are many different services that crisis beds or safe havens. It is important that people who need can provide these assessments, but If people need help in times of crisis help are offered the support and the they are not all available throughout we want to ensure that there is a best treatment for them at the earliest the 24 hour period and because most rapid response with a range of help opportunity. Everyone is different and health and social services do from immediate home support, safe these services need to offer more separate assessments, people at the havens near to their home, as well as, choice on treatments, as well as help moment may have to see more than good quality specialist hospital with housing, finances and one person to get the help they need. services according to people’s family issues. This results in unnecessary delays needs and wishes. and confusion. If people need more long-term or specialist help, they should be We want to change this so that quickly seen by specialist mental people see one person, who is easy health and social care services for to get in contact with and who will assessment and access to the ensure that they receive the service services they need. they need. These staff will also provide advice and information on mental health matters. A Our commitment to improve services

Services for people Services for people Help for carers with long-term and more with memory problems serious mental health There are many unsung heroes in and social problems People who experience problems as Lancashire - extraordinary people, a result of memory loss, head injuries who care for and support members People with longer-term mental ill and other traumas to the brain, of their family and friends. Services health need access to good require different interventions from for these carers are currently treatment and support to help them those with common mental health provided on an ad hoc basis across recover from the difficulties they problems or mental illness. Currently the county. Some organisations have experience because they are ill. these services are provided by NHS identified carers support workers, but Everyday things like getting work, and Social Services according to generally, these services are accessing training and education, age, usually for people over 65 years. insufficient. There are requirements securing decent housing and having However, a small number of younger on health and social care an acceptable standard of living are people also would benefit from organisations to assess the support harder when you have a similar interventions, but are excluded needs of carers and provide a care mental illness. from services because of their age. plan, particularly if they are caring for person who experiences severe and We intend to ensure that people get Specialist health and social care long-term mental health problems. services need to help people live the help and treatment they need productive, meaningful lives in their irrespective of their age and within We want to improve services local communities. There their own homes where possible. available to carers so that they can has been a lot of bad press in the talk to someone about their problems media about mental illness and we and what help they need. This might need to work harder to educate the be practical day to day help or giving public about the problems people carers time to pursue their own experience and how we can create interests. Some carers may need communities that are safe and help with transport if their relative is supportive for everyone. supported in accommodation that is far away from their home. What next? A

We are committed to developing our ideas further over the coming months and plan to publish our thoughts on what these improvements could mean for local services. We will do this together with people who use our mental health and social care services, their carers and the staff who work in them.

You can expect further information to come on these changes during 2005.

For further information please visit www.lancashirementalhealth.org.uk Or contact:

Janice Horrocks Burnley, Pendle and Rossendale Primary Care Trust 31/33 Kenyon Road Lomeshaye Estate Nelson Lancashire BB9 5SZ

Tel: 01282 610234 If you require a copy of this document in other formats please contact Burnley, Pendle and Rossendale Primary Care Trust on 01282 610234 or at the address overleaf

www.lancashirementalhealth.org.uk