Joint report/presentation of Director of Health and Care (Staffordshire County Council), Chief Executive (Midlands Partnership NHS Foundation Trust) and Chief Executive Officer (North Staffordshire Combined Heathcare NHS Trust).
The Committee considered a joint PowerPoint presentation/report (slides attached at Appendix A to the signed minutes) by the Chief Executive of Midlands Partnership NHS Foundation Trust (MPFT), Chief Executive Officer of North Staffordshire Combined Healthcare NHS Trust (NSCHT) and the County Council’s Deputy Leader and Cabinet Member for Health Care and Wellbeing regarding the Mental Health Burden and 2020 Covid-19 Pandemic in Staffordshire.
Dr. Olubukola (Buki) Adeyemo, Medical Director; Lisa Agell, Head of Mental Health Services; Neil Carr, Chief Executive; Jennie Collier, Managing Director – Staffordshire & Stoke-on-Trent Care Group, from MPFT were present at the meeting.
Peter Axon, Chief Executive Officer; Tosca Fairchild, Assistant Chief Executive Officer; Jonathan O’Brien, Director of Operations and Deputy Chief Executive Officer and; Liz Mellor, Deputy Director of Operations, from NSCHT, were present at the meeting.
Karen Coker, Senior Commissioning Manager (Children & Families, Health & Wellbeing); Dr. Richard Harling, Director of Health and Care, and; Alan White, Deputy Leader and Cabinet Member for Health, Care and Wellbeing from Staffordshire County Council were present at the meeting.
Good mental health was integral to human health and well-being. A person’s mental health and many common mental disorders were shaped by various social, economic, and physical environments. Mental health was therefore facing an unprecedented challenge following the outbreak of the virus owing to its impact on the above-mentioned determinants. Whilst many outcomes were still largely unknown, the mental health of the general population was expected to be adversely affected to a significant degree. Various studies had already been published including:-
· A Survey by Ipsos-Mori which suggested that 49% of respondents were feeling more anxious/depressed; 38% had slept less/less well; 35% had eaten more/less healthy food; 19% had drunk more alcohol; and 19% had argued more with those they live with. In addition, ‘coronavirus fear’ was an issue with 61% of respondents reporting concerns about using public transport; 61 reporting concerns about going to bars and restaurants; 43% reporting concerns about using non-supermarket shops; 67% reporting concerns about the long term impact on their children’s mental health and; only 35% willing to return to their usual place of work.
· A report published by the Centre for Mental Health (May 2020) entitled “Covid-19 and the Nation’s Mental Health”, which suggested that the Covid-19 pandemic was likely to lead to an increase in mental ill health, as a result of both the illness itself and the measures being taken to protect people from the virus.
· A survey conducted by the University of Oxford (April 2020) which indicated that one in five primary age children were afraid to leave their homes and were worried that there would not be enough food to eat during the pandemic (NB. The study also found that for a small number of young people their mental health had improved).
· A survey of young people with a history of mental health needs conducted by Young Minds (March 2020) which identified their top 3 concerns during the Pandemic ie (i) isolation/loneliness; (ii) not having enough food/supplies; (iii) managing mental health/mental health deterioration.
There was also anecdotal evidence to suggest that individuals, households and families, had begun to experience the effects of the virus on their wider determinants of mental health including significant financial hardship arising from the imposition of social distancing rules and lockdown of the economy.
Members noted that the various measures implemented by the County Council to mitigate the adverse effect of the pandemic including:- (i) a Coronavirus Kindness Campaign, which aimed to provide people with helpful information about how to stay well (physically & mentally) during the pandemic; (ii) provision of Staffordshire Connects (an online service directory) which offered several digital support tools to enable residents to find information; (iii) the ‘Reading Friends Service’ which gave people an opportunity to chat and make friends through the enjoyment of books; (iv) access to emergency food parcels; (v) provision of links to and information on the local voluntary sector for the provision of help and support with a variety of tasks; (vi) social care practitioners continuing to support existing clients using telephone and virtual means, for assessments and welfare checks; (vii) information for care providers on the Staffordshire Web including links to Government guidance on adult social care; (viii) ‘Other Help for Providers’ pages on the Staffordshire Web including information, advice & guidance for staff together with circulation of newsletters, engagement sessions and information on the Corporate Intranet; (ix) development of the iLearn staff learning platform which provided a variety of resources to help staff with their wellbeing, as well as opportunities for continued development; (x) a jointly commissioned emotional health & wellbeing service for children & young people which went live on 1 April 2020 and; (xi) virtual Family Hubs developed in all eight Districts/Boroughs provided a point of access for our most vulnerable children, young people, and families.
During their presentation the representatives of the two Staffordshire Mental Health Trusts highlighted:- (i) the extra capacity which had been implemented to deal with the likely increase in demand for mental health services; (ii) the arrangements made in order to maintain access by those who were and were not already known by providers, to services; (iii) the various ‘pathways’ to access mental health services including means of self-referral; (iv) the implementation of social distancing guidelines and implications for access to services by patients; (v) various proactive measures being undertaken to identify and contact people at risk and; (vi) measures aimed at dealing with potential increases in substance (drug and alcohol) misuse.
Members then scrutinised all three organisations closely and held them to account over their respective responses, to date, to the 2020 Covid-19 Pandemic, seeking clarification and asking questions where necessary, as follows:- (i) whether the health sector was adequately resourced to deal with the effects of the crisis in the medium to long term; (ii) the extent of the data contained in the reports/presentations and whether it represented an accurate picture of the current position; (iii) the cultural changes needed within the NHS to improve mental health in wider community by being proactive; (iv) the work of mental health support teams within schools since social distancing measures had been implemented; (v) the role of digital technology in facilitating people’s care needs during lockdown; (vi) the work of Virtual Family Hubs (VFH) (particularly where children were not able to attend schools); (vii) proactive measures taken by VFH to co-ordinate with Partners in the voluntary sector; (viii) arrangements for testing patients prior to discharge into the local community; (ix) the measures to provide low-level support people who were and were not currently known to mental health services; (x) the need to include mental health services in the NHS’s Winter Plan for 2020/21; (xi) inpatient detoxification services available in the south of the County; and (xii) the extent of support given by the Health Trusts’ and County Council’s staff during the pandemic.
In response, the relevant representatives of the Trusts and County Council stated that:- (i) they continued to work with NHS England who had provided £8m of additional funding to support mental health in Staffordshire during the pandemic. Whilst this would help to increase capacity, provision had also been made in the Trusts’ long-term plans; (ii) staff turnover remained low and morale was currently high; (iii) NSCHT were actively pursuing measures aimed at promoting good mental health by engaging with communities and disseminating information; (iv) the data contained in the reports represented the information which was currently available. Unfortunately, many of the long-term consequences of the pandemic on mental health were not yet known; (v) both Trusts had recently undertaken a user satisfaction surveys which had elicited a majority of positive responses; (vi) patients were receiving virtual/on-line assessments where possible and the use of the use of digital technology in patient care had previously been piloted in Staffordshire prior to the outbreak of Covid-19. However, face to face appointments continued to be made where necessary; (vii) currently VFHs were provided in each Staffordshire District/Borough (1 per district) and the County Council had made efforts to ensure that every family had been supplied with the necessary equipment to access this service, where appropriate. In addition there were strong links with many voluntary organisations; (viii) additional bed capacity would be implemented by NSCHT at Bradwell Hospital, in the event further spikes in Covid-19 cases were experienced; (ix) patients at Harplands Hospital were being tested for the virus and appropriate measures taken to prevent transmission where necessary. There had been no outbreaks of Covid-19 in this setting to date; (x) suicide rates in the County were currently at levels similar to those prior to the Pandemic. Measures to prevent suicide and self-harming had been given a greater priority by central government and Staffordshire had been involved in piloting a new model of care which was now being rolled-implemented nationally; (xi) mental health would be included in Trusts’ Winter Plans going forward and their representatives had been involved in regional planning meetings during 2020; (xii) during the pandemic NSCHT had co-ordinated the provision of support to vulnerable members of the community with the Police and partners from the voluntary sector. It was important to maintain these links post Covid and joint working with relevant organisations would help to meet low level need, as necessary and; (xii) Whilst the Trusts and County Council had robust measures in place to support mental health and wellbeing of staff, further details including funding arrangements and contracts with external providers could be forwarded to the Committee, as required.
In response to a question from a Member, MPFT’s Chief Executive undertook to provide details of the support provided by his Trust to Autistic children and their families in the County who were unable to access services digitally during the current lockdown restrictions.
Whilst no concerns had so far been raised regarding the capacity of Human Kind (the charitable organisation who provided substance abuse recovery and treatment services in Staffordshire) to meet the needs of residents during the current pandemic, the Deputy Leader undertook to obtain confirmation from the Organisation and implement any remedial measures as required.
In response to a question regarding a specific case, the Chief Executive of NSCHT Officer undertook to investigate the matter, as necessary, in co-ordination with the Member concerned.
The Chairman then thanked the representatives of the Trusts and County Council for their attendance, an interesting and informative presentation and the opportunity to provide constructive health scrutiny for the benefit of the residents of the County.
RESOLVED – (a) That the reports/presentations be received and noted.
(b) That the contact details of Midlands Partnership NHS Foundation and North Staffordshire Combined Heath Care NHS Trusts’ 24/7 emergency mental health helpline (to be supplied) be circulated to (i) Members of the Committee; (ii) all Staffordshire County Councillors and (iii) Leaders of all Staffordshire District/Borough Council’s for dissemination, as appropriate.
(c) That the Chairman highlights the importance of improving links between NHS mental health service providers and schools having regard to the 2020 Covid-19 Pandemic, with Staffordshire County Council’s Cabinet Members for Learning and Employability and; Children and Young People, as necessary
(d) That the mental health burden arising from the 2020 Covid-19 Pandemic in Staffordshire be monitored closely and that further scrutiny of mental health service providers be undertaken at the appropriate time, as necessary.