Agenda and minutes

The Chair welcomed all attendees to the meeting.

The Chair explained that this meeting would differ from previous meetings as the Committee would not hearing from speakers or residents. Instead, the Committee would discuss and agree the Committee’s formal response to Central and North West London Foundation NHS Trust (CNWL) and North West London Integrated Care Board (NWLICB) as part of the pre business case consultation relating to the reconfiguration of mental health services in Inner West London.

The Chair, on behalf of the Committee, thanked the voluntary and community sector, residents, Professor Jill Manthorpe, Professor Emerita of Social Work at Kings College, NWLICB and CNWL for their contributions.

There were no apologies.

Councillor Dr Mona Ahmed disclosed that she was employed by the NHS as a consultant psychiatrist, but it was not employed by CNWL or NWLICB.

The Chair did not deem this to be a disqualifying interest.

The Minutes of the meeting that will be taking place on 20February 2024 will be published in a supplementary agenda.  

The minutes of the last meeting that took place on 20 February 2024 had not been published and therefore would be considered at the next meeting.

The Action Tracker will be updated, following the meeting of the Committee taking place on 20 February 2024, and published in a supplementary agenda.

The action tracker would be updated once the draft minutes had been published.

The Report of the Inner West London Mental Health Services Reconfiguration Joint Health Overview and Scrutiny Committee will be published in a supplementary agenda, following the meeting of the Committee taking place on 20 February 2024.

The Committee discussed its draft recommendations on the pre consultation business case and highlighted the following;

·         The Mental Health Crisis Assessment Service (MHCAS) model was developed in advance of a formal decision being made. Whilst the Committee agreed that it was a good model and welcomed its use, the Committee questioned the extent to which it could be an alternative to a hospital admission; and

·         The MHCAS model was based on short term intervention and the Committee agreed that the model required community-based services to ensure that patients are referred to such services; and

·         MHCAS was not an alternative to inpatient admissions; and

·         Therefore, the Committee recommendation that further development of MHCAS be undertaken and that it be co-produced with the voluntary and community sector.

·         That the co-production structure be set out noting the differing interpretations that speakers in previous meetings attached to it. The Committee recommended that the meaning of engagement be more clearly defined.

·         That CNWL need to provide more information and clarity on how the MHCAS model, which consist of 12 beds, including capacity for four overnight admissions, would substantially alleviate the pressures on A&E; and

·         There was insufficient information on how patients, who required a bed in the longer term would be supported; and

·         The Committee requested greater information on how MHCAS could contribute to the avoidance of crisis, particularly on promotion of services and cooperation with the VCS.

The Chief Operating Officer (COO) at CNWL acknowledged the Committee’s comments and highlighted the following;

·         MHCAS was not meant to be an alternative to inpatient admissions but to provide an additional pathway where care could be given in a non-restrictive environment; and

·         That inpatient wards tend to be short stays, the average was 32 days, during which time a care plan would be formulated; and

·         A small, but not insignificant number, of patients are admitted for only a matter of hours whilst care, including the administering of medication, is provided.

·         The first stage of treatment would involve administering medication or using therapeutic multidisciplinary teams where that is deemed appropriate.

 The Committee then considered the financial case and highlighted the following;

·         The Committee noted the proposal to recruit 100 additional staff, but it was not clear whether the staff would be based on either borough or their roles; and

·         There had been an increase in referrals to community teams since the closure of the Gordon Hospital; and

The COO clarified that the 100 staff would be based in, and work in, both boroughs and would provide information on their roles.

Action Chief Operating Officer 

·         The Gordon Hospital provided services to the resident population of the Royal Borough of Kensington and Chelsea (RBKC) and Westminster City Council (WCC). The COO acknowledged the large non-resident/transient population and pointed out that the system of commissioning involved treating patients within their local system with the aim of keeping them close to family and friends; and

·         Where the patient is not a UK national and is not a resident or asylum seeker,  ...  view the full minutes text for item 6.

The Chair asked when the Committee will receive the decision-making business case.

The COO explained that, once CNWL and NWLICB receive the Committee’s formal response, work would begin the decision-making business case and that the Committee’s recommendations would be considered along with the feedback received form the VCS and residents during the consultation.

The Response Report will be published in April 2024.

The decision-making business case would go to the NWLICB for consideration in July 2024. The engagement process would be shared with the Committee as part of constructing the decision-making process.

The Committee noted the updated.