Improving Inpatient Mental Health Services for Lambeth Pre-Consultation Business Case Version 9 29/03/2020 Version control Rev Date Description of Prepared by Checked by Authorised by revision V1 31/07/19 1st PCBC SLaM NK MP / DB DB Draft. V2 10/09/19 2nd PCBC SLaM NK MP / DB DB Draft V3 08/10/19 3RD PCBC – Trust ML n/a n/a Internal Revisions V4 24/10/19 4th PCBC SLaM Draft NK MP / DB DB V5 27/10/19 5th PCBC – Trust ML n/a n/a Internal Revisions V6 01/11/19 6th PCBC – Trust LC/ST/ML AK n/a Internal Revisions V7 01/01/20 7th PCBC – Trust ML LC n/a Internal Revisions V8 20/01/20 8th PCBC – KPMG TH/ML LC/EC n/a and haP revisions V9 29/02/20 9th PCBC – Trust ML/LCl/EC/A ML/EC n/a Revisions K/LC 1 Distribution list Controlled copies have been distributed to the following organisations: Copy No Name of holder Company Version issued 1. c/o Emily Webster London Clinical Senate V6 2. Denis O’Rourke Lambeth CCG V6 & V8 Christine Caton 3. David Mallett NHS London V6 & V8 Stuart Saw Simon Foster Paul Plumber 4. Neil Robertson Lambeth Living Well Alliance V6 & V8 5. c/o Lambeth OSC Manager Lambeth Health Oversight and V8 Scrutiny Committee 6. c/o Southwark OSC Southwark Health Oversight and V8 Manager Scrutiny Committee 7. c/o Joint OSC Manager Joint Health Oversight and V8 Scrutiny Committee 8. Public Release Published on the Lambeth V9 Together Website Glossary of Terms Term/ Abbreviation Definition A&E Accident and Emergency ADM Alternative Delivery Model AHSC Academic Health Science Centre AMHP Approved Mental Health Professional CAG Clinical Academic Group CAMHS Child and Adolescent Mental Health Services CBC Community Based Care CBI Confederation of British Industry CCG Clinical Commissioning Group CE Compensation Event 2 CIP Cost Improvement Programme CLARHC Collaboration for Leadership in Applied Health Research and Care CLN Clinical Leaders Network CQC Care Quality Commission CSF Critical Success Factor CYP Children & Young People DEC Display Energy Certificate DMBC Decision Making Business Case DOH Department of Health EI Early Intervention: First Episode Psychosis EIA Equality Impact Assessment ERIC Estates Return Information Collection FBC Full Business Case FOMHS Future of Mental Health Services FSRR Financial Sustainability Risk Rating G&ST Guy’s and St. Thomas’ NHS Foundation Trust GDP Gross Domestic Product GLA Greater London Assembly HACT Housing Associations Charitable Trust HIN Health Innovation Network HLP Healthy London Partnership IAPT Improving Access to Psychological Therapies IEQ Internal Environmental Quality IHP Independent Healthcare Provider IM&T Information Management & Technology IoP Institute of Psychiatry IoPPN Institute of Psychiatry, Psychology & Neuroscience IPSA Integrated Personalised Support Alliance IWG Integration Working Group JHOSC Joint Health Overview and Scrutiny Committees KCH Kings College Hospital 3 KCL King’s College London KHP King’s Health Partners LAS London Ambulance Service LCN Local Care Network LCS London Clinical Senate LGBT Lesbian, Gay, Bisexual, Transgender LWNA Living Well Network Alliance LOS Length of Stay LTC Long Term Condition LTP Long Term Plan LTFM Long Term Financial Model LWA Living Well Alliance LWC Living Well Centres MCP Multispecialty Community Provider NBV Net Book Value NHSE NHS England and NHS Improvement NHSE(L) NHS England and NHS Improvement (London) NHSE&I NHS England and NHS Improvement NICE National Institute for Health and Care Excellence NPC Net Present Cost NPV Net Present Value OBC Outline Business Case OHSEL Our Healthier South East London OPE One Public Estate PACS Primary and acute care system PCBC Pre-Consultation Business Case PDC Public Dividend Capital PIA Privacy Impact Assessment PICU Psychiatric Intensive Care Unit PID Patient Identifiable Data PLACE Patient-Led Assessment of the Care Environment 4 PMIC Psychological Medical & Integrated Care PMO Programme Management Office PPE Post Project Evaluation PPI Patient & Public Involvement PREM Patient Reported Experience Measures PRINCE2 Projects In Controlled Environments PROM Patient Reported Outcome Measures PSCP Principal Supply Chain Partner PTAL Public Transport Accessibility Levels QALY Quality Adjusted Life Years QIA Quality Impact Assessment SEL South East London SLaM South London and Maudsley NHS Foundation Trust SLP South London Mental Health and Community Partnership SOC Strategic Outline Case SOCI Statement of Comprehensive Income SoS Secretary of State STP Sustainability and Transformation Partnership SUAG Service user Advisory Group SWL South West London SWLStG South West London and St George’s Mental Health NHS Trust TRACC Transport Accessibility Calculation WIC Ward In Community WLUG Workstream Leads Update Group WTE Whole Time Equivalent YTD Year to Date 5 Contents Foreword ................................................................................................................................................ 8 Chapter 1. Executive Summary ..................................................................................................... 10 1.1 Introduction ............................................................................................................................. 10 1.2 Context ................................................................................................................................... 11 1.3 Case for Change, Care Model and Expected Benefit ............................................................ 14 1.4 Governance ............................................................................................................................ 17 1.5 Stakeholder Engagement ....................................................................................................... 18 1.6 Pre-Consultation Engagement on the Case for Change........................................................ 18 1.7 Option Development............................................................................................................... 19 1.8 Finance Case ......................................................................................................................... 25 1.9 Implementation ....................................................................................................................... 28 1.10 Key Tests ............................................................................................................................... 28 1.11 Decision Making and Next Steps ........................................................................................... 30 Chapter 2. Introduction .................................................................................................................. 31 2.1 Overview ................................................................................................................................ 31 2.2 PCBC Objectives .................................................................................................................... 31 2.3 Background ............................................................................................................................ 32 2.4 Proposal Development ........................................................................................................... 32 2.5 PCBC Scope .......................................................................................................................... 33 2.6 Parties involved in the production of this PCBC .................................................................... 34 2.7 PCBC Structure ...................................................................................................................... 34 Chapter 3. Context .......................................................................................................................... 36 3.1 The Population and Healthcare Challenges .......................................................................... 36 3.2 Background to the CCG, the Living Well Network Alliance and the Trust ............................. 36 3.3 Overview of the clinical transformation programme and estate strategy ............................... 39 Chapter 4. Case for Change, Care Model and Expected Benefit ............................................... 42 4.1 Introduction ............................................................................................................................. 42 4.2 Drivers for Change ................................................................................................................. 42 4.3 Clinical Case for Change ....................................................................................................... 49 4.4 Care Model ............................................................................................................................. 59 4.5 Expected Benefits of the Service Reconfiguration ................................................................. 63 Chapter 5. Governance .................................................................................................................. 73 5.1 Governance Structure ............................................................................................................ 73 5.2 Role and responsibilities ........................................................................................................ 74 5.3 Use of external advisors ......................................................................................................... 74 5.4 Information Governance Issues ............................................................................................