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NHS Newcastle Gateshead Clinical Commissioning Group

Clinicians commissioning healthcare for the people of Northumberland

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Colleagues chatting

Deciding together, delivering together (adult mental health services)

The CCG’s Governing Body made a decision in 2016 to change the way current adult mental health services are arranged, after a wide ranging public engagement and consultation process over two years.

The Governing Body balanced the views of the public and mental health professionals, alongside best clinical practice and the resources that are available, in order to ensure services are safe and sustainable for the future.

The changes create opportunities to innovate and have a wider range of improved and new community services. The decision provided the opportunity to make improvements by creating new interlinking
community and hospital mental health services to reduce reliance on
hospital stays, shorten the time people spend in hospital and overall improve their experience of services, helping them to recover sooner, stay well and have fulfilling lives.

A key part of the decision was that older people’s mental health services in Newcastle would be consolidated, including the relocation of some hospital wards.

The money released from these changes could then be invested into new and enhanced services to create a better way for people to be supported and cared for in their own communities, minimising the need for inpatient care because new innovative services support them, when they need it.

The different scenarios for services were reviewed by independent mental health experts from other parts of the county, as well as a local expert panel of clinicians, the ‘clinical senate.’ The proposals were also subject to review by NHS England.

The CCG has now proceeded with the implementation of the changes, under the banner of ‘deciding together – delivering together.’ A number of further improvements to mental health services have since been made, and these are set out in our annual reports, as well as our Improving mental health services page.

Below you can find key information relating to the Deciding Together process.

Background

This section tells you about the work we did as part of the listening phase of Deciding Together. All this work informed the case for change.

From the summer of 2014 we started asking people who use mental health services, their families, carers, mental health professionals and service providers for their views on how we could improve the way specialist mental health services are arranged in Gateshead and Newcastle.

We called this process deciding together – and we held a listening exercise over the winter 2014/15.

Prior to that, after hearing concerns from service users and carers, the first stage of early listening began which included a series of listening events planned by the deciding together advisory communications and engagement group.

We published a discussion document which described the background to why we need think about these issues.

We published feedback in April 2015 and after further consultation, the CCG’s Governing Body made its decision on the future shape of adult mental health services in June 2016.

You can find key documents about Deciding Together on our documents page (getting involved section).

Governing Body decision June 2016

CCG Governing Body decides on shape of future mental health services

Below is the CCG’s news release announcing the Governing Body’s decision, dated 28 June 2016.

Mental health services in Newcastle and Gateshead are set to be transformed – reducing the amount of time people will spend in hospital and creating better, more integrated care outside of hospital in the community, and helping people to recover sooner – and bringing them onto an equal footing with physical health care.

NHS Newcastle Gateshead Clinical Commissioning Group’s governing body made its decision to change the way current services provided by Northumberland, Tyne and Wear NHS Foundation Trust (NTW) are arranged, after a wide ranging public engagement and consultation process that has taken place over the last two years.

The governing body has balanced the views of the public and mental health professionals alongside best clinical practice and the resources that are available in order to ensure services are safe and sustainable for the future.

The changes will mean the creation of new in-patient facilities at Newcastle’s St Nicholas’ Hospital, and the opportunity to innovate a wider range of improved and new community services, some that will be specifically provided by community and voluntary sector organisations under future new contracts, that will link with statutory NHS services.

While the decision will mean the closure of Gateshead’s standalone Tranwell Unit, as well as the Hadrian Clinic in Newcastle, it provides the opportunity to make significant changes that will create new interlinking community and hospital mental health services that will reduce the reliance on hospital stays, shorten the time people spend in hospital and overall improve their experience of services, helping them to recover sooner, stay well and have fulfilling lives.

Older people’s services in Newcastle would also change and be consolidated at St Nicholas’ Hospital, closing wards based on the former Newcastle General Hospital site.

The money released from these changes will be invested into new and enhanced services that will create a better way for people to be supported and cared for in their own communities, minimising the need for in-patient care because new innovative services will support them, when they need it.

Dr Guy Pilkington, assistant chair and clinical director for mental health, said:

“As a group of doctors, nurses and senior NHS staff we have a duty of care to our patients and we have thought long and hard and weighed up all the evidence to make our decision.

“The reality is we cannot continue as we are, we have poor in-patient facilities which are not the sort of environment that help recovery. We need better facilities and private areas, better places for therapeutic activities such as the arts, games and the opportunity to be outdoors in fresh air.

“Despite the best efforts of our mental health staff, the way services are currently arranged do not make use of their skills or time. We also know we have problems around the transition into different services, in particular from children to adult services.

“We now have the chance to significantly transform our local services in innovative and creative ways that will ensure mental health services in Newcastle and Gateshead are ready to support the increasing demand for mental health care in the future and give them equal status to physical health care.

“I know that some people will be worried about what these changes will mean to them.

“I want to strongly reassure them that this is our opportunity to put mental health care at the heart of our community services in a way we have not been able to do in the past, and truly take them onto an equal footing with physical health services.

“We have listened to the issues people have raised in particular concerns about travel. We know local community links are extremely important to patients, as is making sure they continue to see familiar staff and relationships.

“We promise to put arrangements in place to ensure that these are dealt with during the development of the new interlinking services, and that our partners help monitor these arrangements.

“These changes will not happen overnight. The transition to new services and ways of working will take a number of months and will be done in a safe and sustainable way. No current service will be stopped until we know that new services are in place and working well.

“I would like to whole heartedly thank everyone who has taken the time to get involved in this process, which has been lively and passionate on occasion.

“We have been supported and regularly challenged by a wide range of mental health organisations and partners whom form the mental health programme board. It is their dedication, enthusiasm and passion for mental health – and their recognition that the community and voluntary sector have a key role to play which means we are able to make this positive decision.

“We heard from over 1100 people, held focus groups, events, surveys and in-depth interviews. We developed new ways of engaging the public, such as participatory budgeting which help empower communities – and these are some of the legacies we take forward as part of our plans to ensure the transformation and sustainability of the NHS in the future.

“There is no health without mental health, by making these changes we have the best possible chance to ensure that people get the high quality services they deserve, and have happy and fulfilling lives.”

The different scenarios were reviewed by independent mental health experts from other parts of the country, as well as an expert panel of clinicians called a clinical senate. The proposals have also been subject to review by NHS England who have assured the case for change against key tests of clinical quality, affordability and public engagement.

The CCG will now press ahead with the development of a detailed business case and programme to enact the changes in a safe and sustainable way.

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    • Working with schools and colleges
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