Left to right, Denis O’Rourke, Lambeth’s visionary mental health commissioner (left) on Collaborative Breakfast safari with Chair David Monk at Loughborough Farm; with David, and Natalie Sutherland, Living Well Network Alliance Development Manager, celebrating work with Nesta https://www.nesta.org.uk/case-studies/transforming-mental-health-services-lambeth/
Below: Denis, in familiar pose saying it as it is… and with GP Adrian McLachlan, CCG Chair, presenting him with THE Love Lambeth mug, at Lambeth’s CCG Board meeting where Denis presented with Lambeth’s Carers Strategy Group of which he has led a successful way forward for the borough’s carers.
The January breakfast said farewell to Denis O’Rourke, leaving his role of Assistant Director Integrated Commissioning – Adult Mental Health (NHS Lambeth Clinical Commissioning Group). Although it was more a ‘see you around’ than a goodbye… watch this space… There was a big thank you for everything he had done over the years as a visionary in driving forward work for the Collaborative.
Denis said thanks for the support and inspiration that had come in all shapes and sizes and had been powerful. In his inimitable style Denis said he was thankful to see loads of great stuff to come out of the Collaborative and that was down to the great people around the table.
Primary Care Networks (PCNs)
Dr Di Aitkin provided an overview of Lambeth Primary Care Networks noting that:
· It has been shaped by policy and in the long term plan there was a guarantee to invest more in primary care over the next 5 years, including changes to out-patients and personalised care with a focus on workforce.
· There are 9 PCNs and each GP practice has joined a PCN in their locality. The network is held together by a network agreement.
· All PCNs have different demographics and patient list sizes.
· Clinical Directors have been in place since July 2019.
· All GPs have also signed up to Lambeth GP Federations, which provide a single voice for GPs.
· The PCNs will have responsibility for delivering seven national services as set out in their contract with NHS England. These include:
1. Undertaking a structured medicines review and optimisation, which is mainly for older people and tailoring people’s medication.
2. Enhanced health in care homes (of which Lambeth has many in the borough).
3. Anticipatory Care, which will have elements of mental health (MH) and could be seen as care planning/prevention… this happens already, just the wording has changed on it.
4. Personalised Care, which will have elements of MH in there.
5. Supporting early cancer diagnosis
6. Prevention and diagnosis of cardiovascular disease
7. Tackling neighbourhood inequalities.
· There was a question as to how tackling inequalities would work, as this needs to run across all areas and not be seen as an afterthought. It was noted that each PCN will approach this differently and there is flexibility in the contracts to do this.
· There was a question as to how PCNs will approach public engagement and where it fits in their role.
· There was a question about the role of clinical directors and the role of appeals; if it can’t be dealt with in the surgery, will they step in? Di agreed to take this back to the PCNs.
· There is scope for PCNs to specialise; PCNs are putting forward their aspirations. At this stage there are no specific leads for different areas, including mental health.
· There will be a new workforce for PCNs including:
o Clinical pharmacists
o Social prescribing link workers
o Physician associates
o First contact physiotherapists
o First contact community paramedics
· Di noted that in her practice her front desk staff triage patients to ensure they are seeing the right person. Although there have been some hiccups it has been going well. Di noted that a paramedic will be aligned to the practice.
· Each PCN is currently trying to complete a maturity index. This is what they put forward to demonstrate that they have the right infrastructure to manage income requirements and the risks.
· It was agreed to talk about the staying well offer at the next Collaborative meeting and look at how we provide support for people in the context of primary care who no longer require intensive long-term support.
· There is also a developmental approach looking at how this aligns with the Neighbourhood Alliance.
· It was agreed to come back in June or July on the development of PCNs.
Denis provided an update on the Mental Health Employment Strategy noting that:
· The local authority employment strategy will be completed by March 2020.
· Setting up bi-monthly lunch and learn sessions and looking at taking forward key recommendations in the Mental Health Employment Strategy.
· Black Thrive has been successful in a bid to GSTC (Guy’s & St Thomas’ Charity) linked to the long term condition programme and will be looking at different ways of trialling employment services in the borough. Victoria to send through details of the person at BT to find out how to recruit people.
· The Sanctuary was quiet in December compared to the rest of the year. Thought it would have been busy over Christmas, however it wasn’t.
· Some work is being done to review the Sanctuary and will look at who is referring and why.
· It was noted that it seems Sunday and Monday are the busiest nights.
SLaM Service User and Carer Advisory Group (SUCAG)
· Click HERE for the notes from the Advisory group.
· The group is doing work to evaluate the Single Point of Access and to speak to people with lived experience to see how that is working.
· Alice will send the link around to the group.
Solidarity in a Crisis
· SiaC has new branding. Mathieu to send around the new promotional materials to the group.
· Referrals have been low from GPs and looking to get direct referrals. It was agreed to have SiaC attend the Primary Care locality meetings to talk about the service.
· SiaC are recruiting. Looking to have peer supporters to work in the Living Well Centres; at this point, 7 full-time posts or 15 part-time posts.
· It was agreed to have a Collaborative session focusing on Peer Support in March.
· It was agreed to have a discussion on Culturally appropriate peer support at the March meeting.
· A report is being finalised for Overview and Scrutiny Committee on the Lambeth Hospital redevelopment (waiting to hear if this needs to join with Southwark Overview and Scrutiny Committee).
· There was a pre meeting planned with Lambeth Overview and Scrutiny Committee the following Tuesday.
· There was expected to be a public consultation for 3 months starting February.
· It was thought that we should respond collectively as a collaborative on this.
· It was agreed to add this as a regular agenda item.
· There has been an increase in a number of people seen for a crisis, with 85% being seen on the day they are referred.
· We want to have 6 months worth of running data for the service before it is evaluated and look at next steps.
Forensic Peer Supporters
· There was a question about people wanting to do peer support with a forensic background. SiaC noted that they will not be discriminated against due to their forensic history and that it is on a case by case basis.
· It was also noted that they are also able to join SLaM involvement register.
· It was noted that this could also be discussed at the South London Partnership and the role of Peer workers.
• It was agreed that this could also be addressed at March’s peer support session.
First Step Trust
Burns night is taking place at Abbevilles on 23 January. Tickets are £40, contact Katie Ryan.
FST also launching a youth project that includes catering or driving – please contact Katie Ryan for more info.
Public Health Substance Misuse Review
It was agreed that we would bring the Substance Misuse review, including Dual Diagnosis to a future meeting.