Agenda item

            At its meeting held on 20^th July 2006 the Board considered a report which examined the model of care proposed and the early analysis undertaken by the Council and Halton PCT.

 

            In general terms the view was that the model provided a sound platform to modernise mental health services based upon the model. However, the report highlighted significant concerns about the lack of information, quality of data supplied and uncertainties about the funding issues and invited the 5 Boroughs to respond to these issues. In addition, the Council agreed to commission an independent analysis of the proposals.

 

            It was reported that Halton, Warrington and St. Helens Councils agreed to form a Statutory Joint Scrutiny Committee to scrutinise the proposals and had met on three occasions listening to the views of the 5 Boroughs and the 3 PCTs. A copy of the draft findings of the Joint Scrutiny Committee was circulated to Members of the Board. The concerns raised by the Joint Scrutiny Committee in essence were similar to those contained in the report undertaken by the independent consultant.

 

            Since the report was presented, the 5 Boroughs had continued with their public consultation but at the same time extended the deadline for responses from key stakeholders to the 15^th September 2006. The Chief Executive from the 5 Boroughs had agreed that Halton could formally respond after the meeting of the Executive Board on 21^st September 2006. During the last two months a number of meetings had occurred with officers from the Council, representatives from Halton and St. Helens PCT and the 5 Boroughs Partnership. The report highlighted the processes and identified the responses to the Council’s issues and concerns. In addition, a visit to Norfolk was undertaken by officers and PCT staff to compare the services.

 

            Whilst the Council believed that the principles behind the proposed Model of Care were consistent with the commissioning strategies for Adults and Older People, which were agreed by the Council earlier in the year, there were some substantial risks in the transitition from the current model to the new model proposed. The consultant recommended that the Council supported the proposal on a conditional approval basis and explained why the alternative options were not supported.

 

            In addition, the Joint Scrutiny Commission had made three recommendations, the key one being the model, in its present form, was not in the interest of health services in Halton, St. Helens, and Warrington. Also the Joint Scrutiny Committee had identified 12 factors which required addressing and invited the 5 Boroughs to respond to the issues raised in the report. The guidance on Joint Scrutiny required a response from the 5 Boroughs Partnership Trust within 28 days, a further meeting was therefore scheduled for 19^th October.

 

            Subsequently, it was reported that the 5 Boroughs had made some concessions during the consultation process and had now written to the Council’s Chief Executive committing to a variety of issues, details of which were set out in the report. These concessions and commitments did move the partners closer together, however, the whole systems review may throw up a range of finer issues which would need to be resolved. St. Helens Council Executive Board had also discussed the proposals and their response was detailed in the report.

 

            It was clear that the Trust needed to identify £7m to balance their budget and avoid over-trading in future years. As the whole system’s review had not been undertaken, it was not possible to be entirely explicit of financial impact upon the Council. However, based upon our own analysis and through further clarification, the following financial implications were confirmed:

 

-            Housing and Flotation Support – Halton currently had 35 supported placements to meet the minimum supporting people requirements require an additional 10 units was required at an estimated cost of £210,000 per annum; and

-            Community Teams – to meet the NHS policy guidance the assertive outreach team would need to fund two additional social workers at an estimated cost of £70,000 per year.

 

            It was not possible to estimate anticipated costs upon:

 

(i)            residential and nursing care costs;

(ii)        out of area placements;

(iii)            rehabilitation placements;

(iv)       respite care;

(v)        crisis houses (there were none in Halton);

(vi)       other community care costs.

 

            The conclusion, therefore, was that there would be significant financial implications for the Council, some of which were known, others which would require a more detailed financial analysis.

 

            RESOLVED: That the Executive Board:

 

            In principle, conditionally support the model subject to the recommendations made within the Council’s Independent Consultant Report and the Joint Scrutiny Committee report being fully met and implemented.