High level summary of the Richmond Place Committee Wednesday 16 August 2023

Attendees

Cllr Piers Allen, Convenor and Chair of Richmond Health and Wellbeing Board
Jo Farrar, NHS Executive Lead for Kingston and Richmond
Denise Madden, Deputy Executive Lead for Kingston and Richmond
Ian Dodds, Children’s Lead
Anne Stratton, NHS Community Lead
Jummy Dawodu, Director of Operations, Central London Community Healthcare Trust
Tara Ferguson-Jones, Communications and Engagement Lead
Heather Bryan, Primary Care Provider Lead
Nick Grundy, Primary Care Development Lead
Sue Lear, Transformation, NHS South West London ICB
Racel Tucker, South West London & St George’s Mental Health NHS Trust
Lynn Wild, Associate Director Health & Care, Adult Social Care & Public Health, Richmond & Wandsworth

Transformation

South West London and St George’s Mental Health NHS Trust Community Mental Health Transformation Update

The committee was provided with an update on the ongoing transformation programme for community adult mental health services. The transformation is part of the NHS long term ambition to establish new and integrated models of community mental health care to support working age adults and older adults who have severe mental illnesses so that they will have greater choice and control over their care and be supported to live well in their communities.

Members were informed that new investment has resulted in the expansion of the clinical workforce and an introduction of new roles, with a greater focus on interventions and therapies as well as the introduction of tailored interventions from VCSE-led Peer Support and Welfare Advice organisations.

In Richmond, these expanded services are accessible via the borough’s newly established Single Point of Access team and delivered within Integrated Recovery Hubs (IRH) which have replaced the Recovery Support Teams (RSTs):

Richmond Recovery and Support Team is now Richmond Integrated Recovery Hub
Twickenham Richmond Recovery and Support Team is now Twickenham Integrated Recovery Hub.

Members noted the Single Point of Access team offers specialist advice and guidance to partners in general practice without the need for referral through the e-Referral system. Additional benefits of the transformation programme include the recruitment of over 100 new roles in the community attending to assessment and treatment and focussing on improving relationships with partners across the borough. This should lead to smoother transitions across pathways and was hoped would reduce pressure on physical and mental health acute services.

Members sought further clarity on the newly commissioned welfare advice service provided by voluntary sector partners to offer assistance with issues such as welfare benefits, housing and finances. It was considered beneficial if this service was joined up with all the other workforce expertise around in relation to advice, information and guidance on offer.

Members also noted the following update on CAMHS Transformation:

Neurodevelopment pathway – recruitment of new screening post to meet demand in increased Neurodevelopmental Treatment referrals. Digitisation of screening forms being scoped to improve experience and streamline process
Transitions – transition workers now in Kingston and Richmond and defined process for transition from CAMHS to adult mental health services
IAPTUS system development underway to streamline information sharing between providers to improve experience of young people that may receive care from both providers
Automated information sharing between the Trust and schools where young people have given consent. Communications protocol in draft to support awareness of when schools can expect to hear from the Trust
Emotionally Related School Avoidance (ERSA) pilot due to run to March 2024 in Kingston

Integrated Neighbourhood Team (INHT) Update

As a system the concept of Integrated Neighbourhood Teams (INHTs) has been discussed for some time. In 2022 a series of workshops were held with partners across both the Richmond and Kingston systems which culminated in a proposed model and a set of objectives. The Fuller report has brought this work back into focus.

The committee was asked to consider:

– The definition of our integrated neighbourhood teams

– How we reconfigure operational and management infrastructure to successfully deliver INT

– How do we need to adapt existing and build new workforce to deliver the back office and transformation ask.

Members signalled their agreement in principle for the approach and gave support to scope the resource requirements to deliver the programme of work and development of a business case as required.

South West London Investment Fund 2023/24

In 2022/23, NHS England received additional funding worth £200 million for health inequalities, which was allocated to ICBs (through a needs-based approach) to support system plans developed with health and care partners. The Health Inequalities Fund for 2023/24 sees a further £4.3m health inequalities funding available to South West London with Richmond being allocated £176k for existing schemes and £58k for new schemes.

The funding for successful schemes will be authorised to run until the end of March 2025.

It was noted that the funding should: Be directed towards the services and populations who face the largest inequalities in access, experience, and outcomes.

Maintain work to reduce health inequalities, such as the NHS five priority actions, the Core20PLUS5 approach, while achieving financial balance and elective recovery.
Be considered by systems for use in High Intensity Use programmes which can support Urgent and Emergency Care pathway pressures whilst at the same time addressing health inequalities.

The committee heard that the scheme is expected to launch in the autumn and that the process for reviewing the health inequalities projects to be taken forward at place level needs to be agreed in September. The committee also heard that the Richmond schemes for 2022/23 are currently being reviewed and a report on this will be provided later in the year.