Bassetlaw Clinical Commissioning Group
NHS / Health Body
Action Planned
The CCG is working with Nottinghamshire Healthcare NHS Trust on a transformation programme to meet the NHS Long Term Plan requirements over the next 5 years, with increased access to psychological therapies. Monthly transformation meetings have commenced in June 2020. (AI summary)
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Dear Mr Clow
Re: Regulation 28: Report to prevent future deaths
I am writing in response to the Regulation 28 report to prevent future deaths that was received by NHS Bassetlaw CCG on 23rd April 2020, information has been provided on each of the points that were raised and is outlined below.
In the Regulation 28 report to prevent future deaths you stated that:
1) The Joint Commissioning Panel for Mental Health’s Guidance for Commissioners of Community Specialist Mental Health Services expresses an expectation that there would be more than one clinical psychologist for each Community Mental Health Team, given that clinical psychologists are referred to in the plural within discussions of an appropriate staff team for CMHTs whereas, for example, consultant psychiatrists are referred to in the singular.
(2) CMHTs in Nottingham and Nottinghamshire have a commissioned establishment of, at most, one clinical psychologist per team, with some teams having only a part time clinical psychologist post. This inevitably results in some patients, as here, having no access to clinical psychology when this is clinically indicated, creating an ongoing risk of preventable future deaths.
NHS Bassetlaw CCG (BCCG) has taken the following actions with regard to this issue;
The BCCG is working in partnership with Nottinghamshire Healthcare NHS Trust (NHT) on a programme of transformation to meet the requirements of the NHS Long Term Plan (LTP) over the next 5 years.
The national requirement in 2019/20 and 2020/21 is to ‘stabilise and bolster’ core community mental health teams, increasing team capacity and appointment availability. In 2019/20 this included funding for additional Clinical Psychology posts alongside other posts (i.e. pharmacy technicians and administrative support) to support testing new delivery models.
Continued…….
Dr
Chair Chief Officer
The LTP is explicit on how community mental health teams need to be developed, with delivery milestones from 2019/20 to 2023/24 (appendix 1).
The LTP has a strong emphasis throughout on ensuring the provision of high quality, evidence-based mental health services which includes increased access to psychological therapies within the community based offer, as well as an increased focus on psychologically formed therapeutic interventions and care plan formulation through multi-disciplinary team approaches. There is planned investment each year to deliver the LTP ambitions, which includes increased Clinical Psychology provision across a range of services provided by NHT. The delivery of services is monitored by the BCCG and the Transformation plan is reviewed by NHS England on a monthly basis. BCCG have planned monthly transformation meetings with NHT commencing which were due to commence in March 2020. However, this has recently been impacted by the COVID-19 pandemic and has commenced week of 1st June 2020.
Currently, there is an agreed specification for community mental health teams which Healthcare NHS Trust use clinical judgement to determine the exact level of staffing resource required to deliver the aims, objectives and outcomes stipulated within the service specification.
The Long Term Plan, which I have referenced above, provides a blueprint for standardised service delivery models to be implemented across England, ensuring evidence based models of care are commissioned and delivered, progress to implement a revised service model has already been made in Nottinghamshire.
I hope that this information provides assurance that the BCCG is taking the required action to address your concerns. Please do not hesitate to contact me if you require any additional information.
Re: Regulation 28: Report to prevent future deaths
I am writing in response to the Regulation 28 report to prevent future deaths that was received by NHS Bassetlaw CCG on 23rd April 2020, information has been provided on each of the points that were raised and is outlined below.
In the Regulation 28 report to prevent future deaths you stated that:
1) The Joint Commissioning Panel for Mental Health’s Guidance for Commissioners of Community Specialist Mental Health Services expresses an expectation that there would be more than one clinical psychologist for each Community Mental Health Team, given that clinical psychologists are referred to in the plural within discussions of an appropriate staff team for CMHTs whereas, for example, consultant psychiatrists are referred to in the singular.
(2) CMHTs in Nottingham and Nottinghamshire have a commissioned establishment of, at most, one clinical psychologist per team, with some teams having only a part time clinical psychologist post. This inevitably results in some patients, as here, having no access to clinical psychology when this is clinically indicated, creating an ongoing risk of preventable future deaths.
NHS Bassetlaw CCG (BCCG) has taken the following actions with regard to this issue;
The BCCG is working in partnership with Nottinghamshire Healthcare NHS Trust (NHT) on a programme of transformation to meet the requirements of the NHS Long Term Plan (LTP) over the next 5 years.
The national requirement in 2019/20 and 2020/21 is to ‘stabilise and bolster’ core community mental health teams, increasing team capacity and appointment availability. In 2019/20 this included funding for additional Clinical Psychology posts alongside other posts (i.e. pharmacy technicians and administrative support) to support testing new delivery models.
Continued…….
Dr
Chair Chief Officer
The LTP is explicit on how community mental health teams need to be developed, with delivery milestones from 2019/20 to 2023/24 (appendix 1).
The LTP has a strong emphasis throughout on ensuring the provision of high quality, evidence-based mental health services which includes increased access to psychological therapies within the community based offer, as well as an increased focus on psychologically formed therapeutic interventions and care plan formulation through multi-disciplinary team approaches. There is planned investment each year to deliver the LTP ambitions, which includes increased Clinical Psychology provision across a range of services provided by NHT. The delivery of services is monitored by the BCCG and the Transformation plan is reviewed by NHS England on a monthly basis. BCCG have planned monthly transformation meetings with NHT commencing which were due to commence in March 2020. However, this has recently been impacted by the COVID-19 pandemic and has commenced week of 1st June 2020.
Currently, there is an agreed specification for community mental health teams which Healthcare NHS Trust use clinical judgement to determine the exact level of staffing resource required to deliver the aims, objectives and outcomes stipulated within the service specification.
The Long Term Plan, which I have referenced above, provides a blueprint for standardised service delivery models to be implemented across England, ensuring evidence based models of care are commissioned and delivered, progress to implement a revised service model has already been made in Nottinghamshire.
I hope that this information provides assurance that the BCCG is taking the required action to address your concerns. Please do not hesitate to contact me if you require any additional information.