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Question to the Governing Body meeting in public on 21 March 2017 from Keep Our NHS Public, Birmingham

The question

In 2014, there were a number of questions put to the Birmingham CCGs – Cross-City and South Central regarding the procurement of the 0-25 Mental Health Services in Birmingham.

Now that this contract has been let and ‘Forward Thinking Birmingham’ has been formed, is there any evidence that the delivery of children and adolescents’ mental health services in Birmingham has improved in the last two years?

A recent report to the Board of the lead organisation – Birmingham Children's’ Hospital Trust - has the "Failure to fully evolve and implement the FTB vision" marked as ‘red-risk’, while other board papers talk of aspects of the service that are struggling and also a sense of dissatisfaction with Beacon's performance

What steps are the Clinical Commissioning Groups in Birmingham taking to mitigate the impact of this apparently failing contract on the mental health of Birmingham’s young people?” 

The answer was given verbally by Dr Gavin Ralston, Chair, Birmingham CrossCity CCG:

Part  1 - “In 2014, there were a number of questions put to the Birmingham CCGs – Cross-City and South Central regarding the procurement of the 0-25 Mental Health Services in Birmingham.

Now that this contract has been let and ‘Forward Thinking Birmingham’ (FTB) has been formed, is there any evidence that the delivery of children and adolescents’ mental health services in Birmingham has improved in the last two years?

Answer - The 0-25 Mental Health Services contract was procured in 2014, service mobilisation was phased between October 2015 and the full service was mobilised by October 2016.  The PAUSE drop in centre in Digbeth has been very effective in improving access to advice and support, this is a model that we are now looking to implement for patients over 25. We have also seen a reduction in waiting times for an ADHD assessment, and we have expanded the community eating disorders service and improved access to this. 

Part 2 - A recent report to the Board of the lead organisation – Birmingham Children's’ Hospital Trust - has the "Failure to fully evolve and implement the FTB vision" marked as ‘red-risk’, while other board papers talk of aspects of the service that are struggling and also a sense of dissatisfaction with Beacon's performance

Answer - The mobilisation/delivery of the FTB service has only been in place since October 2016 and therefore performance is still evolving, it has demonstrated some early successes and some challenges, including for example recruitment and retention of the workforce, which is an issue for all mental health providers.  High levels of new referrals continue into the system and demand and capacity are challenging which is leading to patients being placed in beds out of area.  In response the CCG’s have commissioned an external review into the demand and capacity for both community and inpatient services and recommendations will be agreed and presented back to the CCG Governing Body in May 2017.  In relation to Beacon, which is a new patient record system. This has led to a number of data quality reporting issues which are subject to a data quality improvement plan.

Part 3 - What steps are the Clinical Commissioning Groups in Birmingham taking to mitigate the impact of this apparently failing contract on the mental health of Birmingham’s young people?”

Answer - Birmingham South Central CCG co-ordinates Contract and performance management of the FTB contract on behalf of all commissioners. 

In summary the steps are:

  • Regular contract and performance meetings, focusing on:
  • Quality and safety
  • Demand and capacity, linked to overall cost of the contract
  • Mobilisation progress
  • Progress with regard to any identified improvement areas

As stated earlier full service mobilisation is at an early stage and we are working with partner commissioners and FTB to work through any identified issues.  I think it is worth stating that we are committed to commissioning excellent services for children and young people and will be working to address the issues that I have highlighted in this response.

Members of the public may be keen to hear that a progress report on FTB is scheduled for May Governing Body meeting when we will work through progress since full mobilisation in more detail.  Finally if it would be helpful to provide a written copy of this response, or if colleagues would like to meet CCG staff then we can make arrangements for this happen.

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