Welsh Health Specialised Services Committee Mental Health Strategy 2022-2028 Summary

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This draft document outlines the ambitious strategy of the Welsh Health Specialised Services Committee (WHSSC) to commission high-quality specialised mental health services for the people of Wales. The strategy focuses on a whole-person approach to mental health, aiming to provide equitable outcomes for all patients in Wales. Developed in response to recent mental health service reviews, the strategy emphasizes prevention, treatment, and recovery, with input from various stakeholders to ensure a comprehensive perspective.


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  1. WELSH HEALTH SPECIALISED SERVICES COMMITTEE (WHSSC) MENTAL HEALTH SPECIALISED SERVICES STRATEGY FOR WALES 2022/23-2027/28 DRAFT DOCUMENT Summary Version

  2. Foreword Foreword This Mental Health Strategy 2022-2028 (the Strategy) sets out our ambitious whole person approach to commissioning (buying) specialised Mental Health services on behalf of the seven Health Boards for Wales. Mental health and emotional well-being, is a clear priority within Welsh Health Specialised Services Committee (WHSSC), and the Strategy has been developed to show how we intend to meet that priority. Mental health issues have impacted most people s lives through personal experience, caring for a family member or supporting friends or colleagues. Many mental health conditions will be preventable, and almost all are treatable, so people can either fully recover or manage their conditions successfully and live healthy, happy and productive lives. This strategy aims to ensure the commissioning of high quality specialist mental health services for the people of Wales and for equitable outcomes for all patients in Wales. We want this plan to be delivered with the same spirit of ambition, creativity, compassion and collective effort that has characterised the nation s response to the pandemic s threat. Sian Lewis Managing Director of WHSSC

  3. Introduction Introduction The Welsh Health Specialised Services Committee (WHSSC) works on behalf of the 7 Health Boards in Wales to buy high quality specialist services for the Welsh Population. Specialised services support people with rare or complex conditions. It works through a variety of commissioning teams to plan, secure and evaluate specialist services for the people of Wales. One of the commissioning teams has a focus on Mental Health and Vulnerable Groups. Services are delivered by Local Health Boards across various NHS sites in Wales and by NHS providers in England. The independent sector is also used across mental health in both England and Wales.

  4. Why do we need this strategy? Why do we need this strategy? There have been a number of reviews of mental health services lately, and the strategy has been developed to pull together the recommendations from these reviews in order to improve our services over the next 5 years.

  5. How we have developed this strategy How we have developed this strategy We have worked together with Health Boards, NHS organisations and the voluntary sector through a number of key workstreams to talk about the things we need to do to improve our mental health services. Each workstream has been led by either a service provider or commissioner and members came from all health boards and our key partners to make sure we had a variety of viewpoints and opinions. The strategy has then been developed with all of these discussions in mind and sent out to interested people and organisations (Stakeholders) for them to feedback their thoughts on the document.

  6. CAMHS and FACTS CAMHS and FACTS CAMHS is our Child and Adolescent Mental Health Services and FACTS is the Forensic Adolescent Consultation Treatment Service KEY RECOMMENDATIONS: To assess and consider the CAMHS inpatient estate with particular emphasis on the NWAS (North Wales) Site To consider a National CAMHS Inpatient Referral Hub To consider funding an electronic clinical records system To undertake a comprehensive needs assessment for CAMHS inpatient services To consider staffing models at both units to meet the needs of the service specification Stabilisation of the FACTS service and development of a service specification

  7. Eating Disorders Eating Disorders KEY RECOMMENDATIONS: To establish an Eating Disorders Unit for Wales for both in-patient and Day Service Provision across all ages. Urgent interim measures to be put in place following the notice given for Welsh eating disorder placements contract with NHS England Full review of Eating Disorders In-patient services to be conducted by 2023 Developing our workforce Expansion of Paediatric Support for inpatients in Welsh NHS Units Expansion of Health Care Support Worker role in adult eating disorder services Review of Naso-Gastric (NG) Feeding pathways Support for strengthening of Community provision Day Services In-reach/Out-reach Model National Eating Disorders Team

  8. Learning Disabilities Learning Disabilities KEY RECOMMENDATIONS: All secure hospital care including low secure to be commissioned by one organisation: To develop and implement a blended model of care in conjunction with secure service provision in NHS Wales Ensure regular review of Learning Disabilities patients in placements reinforcing the care co-ordination and gatekeeping role Consider a the role of the community Learning Disabilities team to support forensic requirements Development of Electronic Records for Learning Disability Patients in NHS Wales Development of an All Wales demand and capacity inpatient data dashboard

  9. Mens Secure Services Men s Secure Services KEY RECOMMENDATIONS: To develop Integrated Secure Services To consider the requirements of the secure services estate (buildings) in Wales To develop an All Wales Forensic Secure Services Board Development of Electronic Records for Secure Services in NHS Wales To undertake a staffing development and modernisation programme for the two NHS Wales medium secure units. To conduct a needs assessment for secure services in Wales

  10. Womens Secure Services Women s Secure Services KEY RECOMMENDATIONS: To consider the commissioning arrangements for a regional secure service for both medium and low secure service for women To consider the requirements of the secure services estate in Wales To consider establishing a robust Community Model Pathway for women To consider the workforce skill mix to adapt to the increasing acuity of female patients in medium secure services To develop an All Wales Forensic Secure Services Board Development of Electronic Records for Secure Services in NHS Wales

  11. Perinatal Mental Health Perinatal Mental Health KEY RECOMMENDATIONS: To consider the 12 month review of the Mother and Baby Unit (MBU) at Tonna Hospital to be conducted in Quarter 1 of 2022-23 To advise following this review the long-term plan for the unit, particularly in relation to the location of the unit To work in partnership with NHS England to secure 2 beds for Welsh patients in a new unit scheduled for development within Cheshire and Wirral Partnership Trust.

  12. Neuropsychiatry Neuropsychiatry KEY RECOMMENDATIONS: To address the sustainability of the Welsh Neuropsychiatry Service To ensure the Welsh Neuropsychiatry Service reaches across the whole of Wales Improve the flow of patients across the whole patient pathway Raise awareness and understanding in local areas of the enduring impact of an acquired brain injury on mental health

  13. Key Themes Key Themes A blended approach to service development The blended approach aims to limit the labels used for low and medium secure services and provide simple pathways for patients. The commissioning of secure care services be consolidated to be commissioned by one organisation for secure care for men and women, to be inclusive of those with a learning disability where secure requirements are prevalent and it is appropriate to do so. To develop an All Wales Forensic Secure Services Board to provide quality assurance, care co-ordination and gatekeeping provision for secure services. Electronic records An electronic records system be developed in partnership with Digital Health and Care Wales (DHCW) and implemented to cover mental health services across NHS Wales.

  14. Key Themes Key Themes Estates (Buildings) A modernisation agenda for the development of estates to be considered for capital funding in order to achieve optimum service provision, effectiveness of care and efficiency of use of public funds. Response to the Impact of Provider Collaborative on Welsh Patients Urgent consideration for eating disorder services to ensure continuity of provision for our patients following the notice served on our current contract with NHS England. Urgent impact analysis required to assess other contracts which may be served notice from NHS England and alternative solutions as outlined for eating disorder services above.

  15. Next Steps Next Steps Stakeholder Survey 10th May 6th June 2022 Feedback from Stakeholder Survey to inform amendments to strategy document Approval through WHSSC due process mechanism Anticipated publication of final strategy Winter 2022

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