Agenda item

Debra Elliott, on behalf of NHS England, will provide an update on work undertaken to deliver ‘parity of esteem’ between mental and physical health and on specialist commissioning for mental health.

Colonel Smith will also be in attendance and will provide an update on mental health and the impact of the army rebasing programme following discussions at the Military Civilian Integration Partnership.

Debra Elliott, NHS England, presented a report on the work undertaken to deliver parity of esteem between mental and physical health as well as an update on specialist commissioning of mental health. 

Parity of Esteem

The report highlighted that parity between mental and physical health was expected to result in significant improvements to the health and wellbeing of the population and would reduce the financial pressures both in the short and long term.

Although a parity of esteem programme was being developed, 3 key areas, as detailed below, had already been identified for initial focus and improvement:

·         Access to psychological therapies (IAPT) by March 2015

·         Diagnosis and support for people with Dementia by March 2015

·         Awareness and focus on the duties within the Mental Capacity Act

An evidence gathering exercise had been undertaken and presented to the House of Lords in March 2014, resulting in the latter priority following concerns raised over the duties and expectations of CCGs in relation to the Mental Capacity Act. 

Within the Bath and North East Somerset, Gloucestershire, Swindon and Wiltshire (BGSW) area an organisation had been commissioned to work alongside NHS England to address the above themes with an interim report expected in July and final report in September 2014.

A number of websites provided information on good practice, tools and guidance which was recognised to be important for commissioners to enable them to deliver the national requirements.  Intensive support was also being developed to support CCGs in delivering the national ambitions, further details of which were available on the IAPT website.

Specialised commissioning

143 specialised services were commissioned by NHS England, 11 of which related closely to mental health.  It was understood that a programme of work was being developed and was likely to be completed by the end of July when a further update report would be provided to the Board.

Patient Right to Choose

After presenting the report, Debra Elliott confirmed that NHS England had now published interim guidance on Patient Right to Choose.  A link to the website could be found below:

http://www.england.nhs.uk/2014/05/21/guide-published/

Commissioners, GPs and Providers were asked to give consideration to the interim guidance and provide any comments to NHS England no later than 5pm on Friday 15 August.

Major Dickie Gittins and Tony Jackson were welcomed to the meeting to provide an update on mental health services for army personnel which included recognition of the importance of mental health services required by army personnel including veterans, many of which had a desire to remain in the county.

Monthly case conference meetings included attendance by AWP representatives and helped with the transition into civilian life.  There was awareness that the numbers were likely to increase in the future.

Tony Jackson confirmed that although the welfare service was outside the chain of command of the army, it worked alongside the army to provide support to army personnel and their families within the area.  The service was currently undergoing a review in consultation with senior management. 

The Board noted that approximately 11,000 soldiers were based within the Salisbury area alone which was likely to increase by a further 4,500 as a result of the army rebasing programme.  The welfare team consisted of 35 personnel for the Wiltshire area alone and therefore the review was welcomed.

It was recognised that a fundamental change in the way services were commissioned was needed together with a change in the public’s view to mental health problems.   Wiltshire was in a strong position noting that joint commissioning arrangements were already in place although these might need to be refreshed in light of parity of esteem findings.

The Chairman highlighted the importance of focusing on prevention and in helping individuals to help themselves and the benefits this would have for health and wellbeing as a result. 

Thanks were given to the presenters and the Chairman looked forward to receiving further demonstrations that parity of esteem was developing well in the future.