Agenda item

Rachel Corser (Chief Nursing Officer BOB Integrated Care Board) and Dan Leveson (BOB Integrated Care Board Oxfordshire Place Director) have been invited to present a report on Adult and Older Adult Mental Health in Oxfordshire. Also invited to be in attendance are: Chris Wright (Assistant Director of Partnership Development, BOB Integrated Care Board) Catherine Sage, Lola Martos (Head of Adult Services OUH NHS FT), Manny Jhawar-Gill (Commissioning Manager, Adult Social Care, OCC) and Pippa Corner (Deputy Director of Commissioning, Adult Social Care, OCC).

The Committee is invited to consider the report, raise any questions and AGREE any recommendations arising it may wish to make.

Dan Leveson (BOB ICB Place Director for Oxfordshire), Chris Wright (Assistant Director Partnership Development, Oxfordshire), Lola Martos (Head of Older Adult Services at Oxford Health NHS Foundation Trust), Manny Jhawar-Gill (Commissioning Manager, Improve Enable, Adult Social Services, OCC), Pippa Corner (Deputy Director Commissioning, Adult Social Services, OCC), Nicola Leavesley (CEO of Response and current Chair of the Oxfordshire Mental Health Partnership, OMHP), Catherine Sage (Head of Service for Mental Health Urgent Care, Social Care, and Adult Eating Disorder Service, Oxford Health), Jared Fellows (Health Improvement Practitioner, Public Health, OCC), Karen Fuller (Director of Adult Social Care, OCC), and Ansaf Azhar (Director of Public Health, OCC) presented a report on Adult and Older Adult Mental Health in Oxfordshire.

The Committee first inquired about the adult eating disorder service, specifically the contract between the BOB ICB and other providers covering community eating disorders. They asked about the extent to which these services were dealt with separately or as part of the overall mental health aspect, and the level of specialist provision available. The BOB ICB Place Director for Oxfordshire explained that specialist adult eating disorders services were commissioned on a larger scale through specialist commissioning, with Oxford Health as the lead commissioner. He clarified that the community services were delivered locally and were part of the system they worked on together. The Head of Service for Mental Health Urgent Care added that the regional services primarily included inpatient services and some intensive treatment services to avoid admission or support post-discharge. She mentioned that Oxfordshire had one inpatient service at Cotswold House in the Warneford Hospital and that the community adult eating disorder service covered the entire county.

The Committee then asked about the engagement of older adults, specifically those over 65, in the design and commissioning of older adult mental health services. The Head of Older Adult Services emphasised the importance of engaging service users and carers through active groups and working closely with the voluntary sector. She acknowledged the difficulties faced by older adults to have their voices heard, and this concern was always at the forefront of the service’s efforts. The BOB ICB Place Director for Oxfordshire added that Oxford Health had a long history of person-centred, goals-based care, and that patient feedback was integral to service design. The Assistant Director of Partnership Development at Oxford Health highlighted their strategic initiative to increase patient involvement in care, surpassing their 80% target with 88% of service users reporting participation. This approach aimed to enhance patients’ experiences and inform service delivery and commissioning decisions. Additionally, they planned to consolidate services for older adults and eating disorders under a single contract to offer a broader range of interventions. Patient surveys and external reviews were conducted to understand current service perceptions and identify gaps and challenges.

The Committee raised the issue of loneliness among older adults and asked about measures being taken to address this. The BOB ICB Place Director for Oxfordshire acknowledged the challenge, citing factors like rurality and transient populations. He highlighted various initiatives, such as the Move Together programme and Integrated Neighbourhood Teams, aimed at bringing people together and fostering community engagement. The Director for Public Health also mentioned the establishment of community hubs funded by Community Capacity Grants. He highlighted the Mental Health Prevention Concordat, a quarterly partnership focusing on enablers like green spaces, voluntary sector resources, and addressing different settings such as residential care and maternity. The approach aimed to systematically bring partners together to enhance mental health services, ensuring no one was overlooked, and to build workforce confidence in providing better mental health support.

The Committee asked about the extent of research collaboration with academic and voluntary sectors to improve mental health services. The CEO of Response and current Chair of Oxfordshire Mental Health Partnership (OMHP) expressed the need for more research and understanding, particularly in providing holistic services and prevention work. She noted the challenges of funding and resources but emphasised the sector's commitment to engaging communities and delivering flexible services.

The Committee inquired about the outcomes-based contract, which was coming to an end in March next year. They asked about its success, future plans, and evaluation methods. The BOB ICB Place Director for Oxfordshire explained that the outcomes-based contract was a pioneering model that linked payments to outcomes, although measuring outcomes had proven challenging. He mentioned that the contract had evolved over time, with a focus on delivering better value care through integrated pathways.

The Committee then turned to specific issues around suicide prevention and workforce support. They asked about the influence of the 2023 National Suicide Prevention Strategy on local efforts, stakeholder input, and training for professionals. The Health Improvement Practitioner explained that the local strategy was being refreshed to align with national priorities, with a focus on high-risk groups and targeted training. He reported that local suicide statistics and risk factors in Oxfordshire were consistent with national trends, with drugs, alcohol, relationship breakdowns, and bereavement being the leading risk factors for men. The male-to-female suicide ratio in Oxfordshire was lower than the national average, with 60% male and 40% female. At the end of the previous year, Oxfordshire Mind was commissioned to deliver a suicide prevention and mental health training programme, which began in January. This programme targeted key groups identified in national strategies, such as middle-aged men, pregnant women and new mothers.

The Committee also asked about the transition between different mental health services and the potential risks involved. The Head of Service for Mental Health Urgent Care acknowledged the challenges but assured that mechanisms were in place to ensure smooth transitions and minimise risks. She highlighted the importance of maintaining patient history and effective communication among professionals.

Finally, the Committee addressed the issue of detentions under Section 136 and the high rate of admissions to adult acute psychiatric beds in Oxfordshire. The Head of Service for Mental Health Urgent Care attributed this to the lack of a countywide crisis resolution home treatment team, which was a known gap in provision. She mentioned ongoing plans to establish such a team and improve crisis care.

The Committee AGREED to delegate to the Health Scrutiny Officer and the Chair to finalise the wording of the recommendations.