Mental Health (Care and Treatment) (Scotland) Act 2003. Forth Valley Joint Local Implementation Plan Review June 2005 Area-wide Elements. 1. Introduction E:\Mike\2005-06-00 Forth Valley JLIP Update - Area Wide.doc This document represents the update of the Forth Valley Joint Local Implementation Plan (JLIP) describing the issues that have been agreed by partner agencies as area-wide issues. This paper should be read in conjunction with previous JLIPs, and should also be read in conjunction with the three local authority JLIPs as all four documents complement and support each other. 2. Key Principles and Priorities As before, the continuing development of the JLIP will proceed on the principles of effective joint working (as set out under the Joint Future initiative) with reference to the duties and requirements of the new Act. The JLIP will be augmented further by the ongoing development of detailed implementation plans for each council area (Clackmannanshire, Falkirk and Stirling) which have been approved by respective Council Committees. The main priorities from previous JLIPs included the following, and actions taken to address these issues are also noted:- Appointing a jointly funded temporary Project Manager to take forward the JLIP. 2.1.1 A Project Manager was appointed in August 2004. 2.2 Enhancing Independent Advocacy Services for all care groups. 2.2.1 Independent advocacy providers are currently being approached and requested to establish a pilot service for children and adolescents affected by mental health issues, as this group was seen as a priority. Further work is also being done to identify any other gaps in service and to ensure that all care groups have access to appropriate independent advocacy services. 2.3 Developing relevant Training Programmes for everyone involved with the new Act. 2.3.1 A Training Sub-Group has been established to address training issues. Training courses for MHOs have now been completed. Training courses for other key groups are being held during June August and September 2005, and will cover NHS staff, LA staff, and staff from the non-statutory sector. The NES web-based training will also be utilised where appropriate. 2.4 Putting in place effective joint processes and organisational structures to ensure the Act is implemented as required. 2.4.1 The Forth Valley Mental Health Act Steering Group has been established to oversee the key actions required to implement the Act. This group has delegated authority to ensure that service development priorities are identified and agreed and that the partnership funding is allocated appropriately. A number of sub-groups have been established to address specific issues such as Training, Tribunal Accommodation, Independent Advocacy for children and adolescents, Psychiatric Emergency Plan, and Advance Statements. These sub-groups report to the Forth Valley Mental Health Act Steering Group. Each local authority also has Mental Health Act Steering Groups operating on a similar basis. 2.5 Agreeing the key service development priorities and identifying bridging processes that will support extensive local redesign. 2.5.1 The Forth Valley Mental Health Act Steering Group has delegated authority to ensure that service development priorities are identified and agreed and that the partnership funding is allocated appropriately. Service developments have now been prioritised, and are highlighted below. 3. Organisational Structures and Joint Planning Context E:\Mike\2005-06-00 Forth Valley JLIP Update - Area Wide.doc 2 3.1 Joint Planning Arrangements Forth Valley has a mature, joint planning structure which has been in place for a number of years and which has been subject to regular review. The Forth Valley wide Mental Health Strategic Implementation Group provides strategic direction and overview of the process of implementing the Framework for Mental Health Services and the local Mental Health Strategy as the vehicle for implementing the framework. The Strategy Implementation Group has recently reviewed the local strategy and agreed its key priorities for mental health. The Strategic Implementation Group is supported by three local Framework Implementation Groups, which look to agree and implement local priorities for mental health. These groups include user and carer representatives and link directly to Joint Future Management structures. 3.2 A Joint Future for Mental Health Services Joint Future arrangements are well developed in Forth Valley, with clear decision making structures in place. Implementation plans are in place to establish Joint Management of Mental Health Services in each of the local authority areas, and there are clear links with the local Framework Implementation Groups. Good progress is being made in developing integrated community mental health services in each local authority area as follows:- Falkirk A model of integrated Community Mental Health Services for adults has been approved by the Joint Executive Group and the Joint Future Management Group and this will be implemented from April 2005. Stirling The model was circulated for comment over the winter months and was agreed by the Joint Executive Group in February 2005. It has been remitted to the Joint Future Joint Managers Group for further development commencing in September 2005. Clackmannanshire Day services in Clackmannanshire Council area have been successfully integrated for over a year. However, work is in progress to consider how the Community Mental Health Teams might become part of the integrated model. The Joint Future infrastructure provides a solid basis for further integrated developments to support the requirements of the Mental Health Act. 3.3 Planning for the Mental Health Act As stated above, a Forth Valley Mental Health Act Steering Group has been established to oversee the development of this Joint Local Implementation Plan. This group reports to the Forth Valley Mental Health Strategic Implementation Group and to the Joint Future Management Groups. 3.4 Mental Health Services in Forth Valley – Redesign Process Mental Health Services in Forth Valley are undergoing a process of review and redesign which will see significant and far reaching changes in the way specialist mental health services are delivered. A significant change will be the centralisation of all acute inpatient assessment beds (adults and older people) in the new acute hospital planned for Forth Valley in 2009. However, current pressures on services, including those arising from the Mental Health Act, will require interim arrangements to be put in place within the timescale for the implementation of the Act. Consequently, the development of this local implementation plan for the Mental Health Act should be seen in the context of the overall E:\Mike\2005-06-00 Forth Valley JLIP Update - Area Wide.doc 3 redesign of Mental Heath Services. A critical area of current activity is to consider what changes in community based services are required, arising from the redesign of acute admission services. There are significant overlaps between the priorities identified for community based services arising from the redesign process, and those identified as requirements arising from the Act. These include crisis services (care & support), extended hours’ services, intensive home treatment and support. These key areas not only encompass specialist mental health services, but also the full range of care and support services for people in their communities. A proposed new Service Model has been jointly agreed and is supported by evidence that suggests the balance of care could move more from hospital to community-based care. These proposed changes were the subject of a formal public consultation process as a key element of Forth Valley’s Healthcare Strategy proposals, and were approved by the Forth Valley NHS Board in September 2004. 3.5 Child and Adolescent Mental Health Services and Peri-natal Services A capital project to create appropriate mother and baby accommodation within Ward 18 at Falkirk and District Royal Infirmary will be completed by October 2005. This includes a partnership approach with the Acute Division to ensure appropriate support for mother and baby is provided from maternity/paediatric services as well as mental health specialists. Given that this mother and baby accommodation may be utilised on a limited basis, consideration will also be given to this accommodation being made available to adolescents, as appropriate – see below. A new development of a Primary Mental Health CAMH Service is being implemented currently. This is a partnership project, jointly funded by the NHS and all 3 local authorities in Forth Valley. This will see an investment of 7 new posts across Forth Valley. Forth Valley is part of the consortia taking forward new inpatient provision for adolescents in the West of Scotland. Locally, there is a need to ensure that adult inpatient accommodation is sufficiently flexible to ensure that any admission of adolescents is in appropriate accommodation. Consideration will also be given to using the developing mother and baby accommodation for adolescents, as appropriate – see above. This is also being taken forward through the planning of the new inpatient facility at Larbert. An audit of Eating Disorder Services is underway currently and will inform a review of local provision to be implemented during 2005. A service proposal/business case is currently being developed to provide services for children with a learning disability and mental health problem and/or challenging