Agenda item

Ms Vanessa Odlin, Managing Director for Hillingdon and Mental Health Services, Goodall Division at Central and North West London NHS Foundation Trust (CNWL), advised that CNWL was responsible for mental and physical health services in Hillingdon as well as mental health inpatient services and a ward for older adults with mental health challenges. 

The Trust had faced some challenges with regard to the waiting list for children’s mental health services.  The Committee had heard from Ms Tina Swain, Service Director for CAMHS & Eating Disorders - Goodall Division at CNWL, at its last meeting about the innovations that had been introduced to reduce the waiting list and the work that had been undertaken to expand the workforce. 

Ms Odlin recognised that the pandemic had resulted in an increase in the number of children experiencing mental ill health and that further preventative work was needed.  To this end, a new model had been introduced for 0-5 year olds as a preventative measure supported by mental health teams to reach children before they went into crisis.  The model was delivered by a small team of clinicians which received referrals from GPs as these children were not yet in school.  The service looked at the whole family to identify what support was needed and what steps could be put in place.  Although this work was not yet embedded, consideration could be given to expanding it to other age groups in the future.  However, it was noted that the mental health teams in schools would cover children up to the age of 11 that were in school.  In addition, work was underway in the community for 0-19 year old physical health and consideration would need to be given to joining this up with the mental health work. 

Ms Odlin advised that Kooth (an online emotional and mental health support service for children and young people aged 11-24) had been embedded in Hillingdon and funding had recently been received to undertake preventative work on CAMHS.  Some of this funding had been given to the Council to allocate through third sector grant schemes.  Although mental health teams were not yet in all schools across the Borough, discussions were underway with North West London Integrated Care System (NWL ICS) to determine how much budget would be needed to achieve total coverage.  It was recognised that this could be more challenging if schools were not willing to engage.  

With regard to adult mental health, Ms Odlin advised that the Crisis Recovery House had opened in the summer and would be piloted over the next 12 months.  During this period, the access criteria would be reviewed.  The house was being run by Comfort Care Services (an independent sector company) in collaboration with CNWL and the local authority and had been borne out of good partnership working.  Although referrals to the Crisis Recovery House could be made at the point of crisis, the purpose of the house was to avoid crisis and for it to be included as part of an individual’s care plan. 

Ms Odlin advised that the Crisis House was not an alternative to the Riverside Centre.  The house was a non-clinical space, had a maximum capacity of 6 and was open to those aged 18 or over.  It was anticipated that the length of stay would be 7-10 days but should be as short as possible.  Each guest staying at the Crisis Recovery House would be reviewed at different points during their stay to determine whether or not they needed to be admitted to hospital.  Mr Gary Collier, the Council’s Health and Social Care Integration Manager, advised that it had taken 18-24 months to get this house up and running and supporting people and had been a true collaboration between health and care providers. 

An evaluation of the outcomes was being undertaken and thought was being given to where each guest would have gone if they had not been referred to the Crisis Recovery House.  Guests that had used the Crisis Recovery House were looked after by the home treatment team after they left the House.  CNWL would like to know from these guests where they would have gone if their referral had not been accepted and would also look at homelessness as part of this work. 

Although the Crisis Recovery House had not yet been at capacity, this had been expected.  An evaluation would need to be undertaken to establish how successful the Crisis Recovery House had been and then consideration could be given to whether or not an additional house was required.  Effort would also need to be made to ensure multiple access points were available into the Crisis Recovery House such as referrals from the police and identifying other professional groups that might need to make referrals.  Ms Odlin would provide Members of the Committee with an update on the Crisis Recovery House in 12 months. 

Members were advised that a video of the Crisis Recovery House had been made to show potential guests what it was like.  A media campaign to raise awareness of the facility was also underway across Hillingdon.  Ms Odlin would forward the video to the Democratic Services Manager for circulation to the Committee. 

Mr Collier advised that an update report on the Crisis Recovery House / The Retreat had been considered at the Health and Wellbeing Board meeting on 29 November 2022.  The report had included detail about needs and about the outcomes of the experience.  The Democratic Services Manager would circulate the report to Members of the Committee. 

Members were advised that a number of Additional Roles Reimbursement Scheme (ARRS) roles had been introduced for clinicians working in primary care supporting people who struggled with their mental health but who didn’t need to be referred to community mental health services.  This had been in place for a couple of months so the impact was yet to be determined. 

For the transition from child to adult services, pathway leads had been put in place for young adults aged 16-25 and pilots were being put in place to help the transition.  Links had been made with Brunel University and the voluntary sector to support this work. 

Insofar as physical health was concerned, Ms Odlin advised that CNWL continued to work with Hillingdon Hospital to support discharge.  In North West London, this work with The Hillingdon Hospitals NHS Foundation Trust (THH) was seen as been a good example of partnership working.  Hillingdon was also an early implementation site for lower limb wound care and Family Hubs had been set up with the Council alongside a website to provide families that needed more support or who wanted to self-help.

The ARCH drop in assessment service had stopped at the start of the pandemic and had restarted this year.  Members were advised that funds had been secured for the ARCH service to provide a day programme and a focus on assessments.  This work supported the inpatient service at Riverside to help dual diagnosis patients on their discharge journey. 

With regard to alcohol-related admissions, Ms Odlin advised that she was only able to speak about mental health inpatients, not acute hospital admissions.  Although ARCH did work into the hospital, there could be more support from addiction services and thought needed to be given to how this could be enhanced. 

Ms Odlin advised that, with regard to the time that the police spent with mental health patients, partners were committed to having regular senior meetings with the police where case reviews were undertaken in a collaborative way.  The Crisis Care Concordat, chaired by Mr Richard Ellis, Joint Lead Borough Director at NWL ICS, had held its first meeting jointly with West London.  Representatives from H4All had been in attendance and it had been recognised that all organisations had a lot of regular contact with a small number of individuals.  As such, individual care plans had been developed for these individuals to meet their needs.  Consideration was also being given to how the Crisis House and Cove Café could be used by the police.  Ms Odlin would provide Councillors Denys and Nelson with an informal update and more statistics in January 2023. 

Members queried what support was available to those individuals who did not have access to digital platforms.  Ms Odlin advised that she would take this back to her team.  She would also ensure that data around performance indicators was available for the meeting in April 2023.

RESOLVED:  That:

1.    Ms Vanessa Odlin provide Members of the Committee with an update on the Crisis Recovery House in November 2023;

2.    Ms Vanessa Odlin forward the Crisis Recovery House video to the Democratic Services Manager for circulation to the Committee;

3.    the Democratic Services Manager circulate the update report on the Crisis Recovery House / The Retreat that had been considered at the Health and Wellbeing Board meeting on 29 November 2022 to Members of the Committee;

4.    Ms Vanessa Odlin provide Councillors Denys and Nelson with an informal update and more statistics on the amount of time police spent with mental health patients in January 2023;

5.    Ms Vanessa Odlin provide the Committee with data around performance indicators at its meeting on 26 April 2023; and

6.    the presentation be noted.