To consider an update presentation in respect of mental health service delivery and response to previous recommendations from scrutiny.
Consideration was given to a presentation by the Care Group Director of Rotherham Doncaster and South Humber NHS Foundation Trust (RDaSH) in respect of delivery of mental health services. The presentation focussed on outcomes including quality and safety, and described recent activity undertaken to clear backlogs in the Memory Clinic and in the Assessment and Formulation Clinic, as well as recent collaboration with Rotherham Speak Up for Autism to develop further the accessible and reader-friendly offer within the Rotherhive online resource.
In discussion, Members requested additional clarification around serious incidents. The response from the Care Group Director provided the official definition as incidents leading to serious harm or death. Brief context of this quality measure was provided.
Members requested a projection for activity in the next six months, given the progress achieved in the last six months. The response from the Care Group Director noted that capacity and demand analysis had been done to consider how the trajectory may continue over time. Staffing levels in both services had changed significantly, with people leaving and joining the Service and with staff sickness. Plans were being revised on an ongoing basis based on the staff resource levels available.
Clarification was sought around whether a target was being pursued regarding appropriate levels of waiting times. The response from the Care Group Director clarified that the national diagnostic target for dementia was six weeks. The national target for the assessment and formulation Service, the 18-week target was not far off. The numbers provided had been indicative and were fluctuating with staffing teams.
The Chair acknowledged that substantial progress to clear backlogs had been achieved amid the workforce challenges and amid rising numbers of referrals.
Members sought assurances that funding provision currently associated with the Locally Enhanced Service would continue, leading to shorter waits over the long term. For the memory service, two pots of money had been received. Substantive additional funding provided for two additional staff members. Some further moneys had been pledged from the ICB if the Service were able to recruit above and beyond their full establishment. There were additional moneys for the short term to help clear backlogs, but staff numbers would be more sustainable if this additional funding from the ICB could be garnered.
Members requested to know more about any pressure points. The response from the Care Group Director noted gaps in doctors as well as in the nursing establishment for several reasons. In the last eighteen months, many clinicians had retired from the profession or move to work in other places.
Members requested to know if bursaries and scholarships were available, especially those for whom there is an underrepresentation within the profession. The response from the Care Group Director noted that there is regular attendance at the University of Sheffield to speak to the nursing students. These visits had received positive feedback. Open days were attended routinely three to four times a year for the last few years. It would be observed if these had follow-on effects for recruitment in the longer term.
Members requested more information about what is driving the increase in referrals. The response from the Care Group Director noted that in terms of adults, at the abatement of COVID, more IAPT self-referrals were expected. What was being seen instead was greater numbers of referrals for secondary services. These were referrals into Assessment and Formulation from GPs. Acuity of patients was more than previously seen. The Care Group had tried to put the staffing levels into place to react to this.
Clarification was requested regarding the availability for funding for trainee students. The response from the Care Group Director noted that trainee nurses and health care support workers have the ability to go on to do their support training with elements of funding in place for that.
1. That the presentation be noted.
2. That the next update be submitted in 6 months’ time.