The Chair of the Committee explained that mental health was one of the five health and wellbeing priorities identified through the Trafford’s Joint Strategic Needs Assessment. Consequently, access to talking therapies and suicide action plan had been chosen as topics to review. In order to gather an impartial and wider picture of the service offer and current situation in Trafford, third sector organisations such as The Samaritans, MIND and Advocacy Focus had been invited to this evening’s meeting, together with officers of the Council and representatives of Trafford Clinical Commissioning Group and Greater Manchester Mental Health NHS Foundation Trust.
In 2017/18, Trafford’s data concerning access to psychological therapies had been lower than the English average and the lowest amongst a group of similar Clinical Commissioning Groups (CCG).
The Lead Commissioner Mental Health and Learning Disability, NHS Trafford, the Consultant Clinical Psychologist and Strategic Lead and the Clinical Lead Trafford Psychological Therapies for Primary Care Psychological Therapy Division of Greater Manchester Mental Health NHS Foundation Trust delivered a presentation to inform the committee of current performance against access targets.
Since 2017, performance in Trafford had improved substantially and, in 2018/19, 21% of adults requiring intervention were able to access therapy, against the national target of 19%. In addition, the recovery rate for 2018/19 was 54.5 against a recovery target of 50%, making Trafford one of top five performers in the North of England. The latest published rolling data for 2019/20 showed that this positive trend continued.
The Lead Commissioner Mental Health and Learning Disability, NHS Trafford, went on to explain that commissioners and providers worked collaboratively to develop a system whose main focus would be on preventative work rather than intervention; a Primary Care and Mental Health and Wellbeing service had been launched in April 2019. The access target was incrementally growing and in 2023/24 would be 31%. This posed a challenge in terms of resources such as workforce and accommodation. The existing on line access to psychological therapy services would need to be widened. Furthermore, a significant issue was represented by the psychological need of people with a long term physical condition who would benefit from psychological intervention. Consequently, another element to develop would be integration with physical health services but also with leisure and voluntary services. Challenges existed with regard to access equitability to ensure that all communities could access services; currently there was a lower access in the north of the borough.
The Consultant Clinical Psychologist drew the attention of the Committee on the fact that the recovery rate continued to improve and, although this was a very challenging criteria to meet, the most recent data reported that 61% of people who completed treatment showed significant improvements to their condition to be classed as recovered. However, investments were necessary to improve access and quality of service for everyone; to increase access of 1%, a fully qualified member of staff would be needed as well as appropriate accommodation to deliver services. On a positive note, comparative data from 2014 showed that Trafford and Stockport were the only local authorities in Greater Manchester where the percentage of people with a mental health disorder had not increased and this was linked to a focus towards the needs of the population. Different initiatives were being implemented to facilitate proportional access to reach people where they were and to enable self-referral also electronically.
Members observed the need to increase the uptake of psychological therapies in the north of the borough to meet the needs of the population and also to develop ability to reach culturally diverse population. Officers explained that measures were in place to address access issues, for example, the Primary Care Mental Health and Wellbeing services had been launched in the north of the borough, links had been developed with GPs and local voluntary services and local communities to encourage as many referrals as possible; officers also looked actively at GPs’ registers of people with chronic health conditions to target those who struggled with managing their conditions. Equitable provision was supported through the promotion of self-referral, access to translation services and informative material available in different languages. In addition to this, there was a strong focus on increasing capacity within the community and strengthening the collaboration between statutory services and third sector. Members queried the availability of on line therapy. Officers explained that they were currently trialling a portable application for access to online therapy to verify the effectiveness of intervention. If the trial was completed successfully, the application would be rolled out in four boroughs, including Trafford. The Committee received clarification on the initial assessment and the Stepped Care Model to deliver and monitor treatment. Officers explained that the coordination of care and medications took place through the GP. The Committee sought and received clarification on ways to measure recovery, reduce stigma to increase access for men at high risk of suicide. Members queried about social prescribing. Officers stressed the importance of shifting concept from service delivery to building capacity in the community through engaging with local people, third sector, faith centres, etc.
1. That: the content of the presentation be noted;
2. That: a progress report be presented to this Committee in March 2020 updating on access to services in the north of the borough, access to on-line therapies, relapse rate and attrition rate in patients.