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Joint Hampshire Commissioning Strategy for Older People’s Mental Health

2008/09 Summary Impact Assessment

Department: Adult Services

Date: March 3/04/08

Completing Officer’s Name: Catherine Pascoe

This strategy specifically targets a relatively disadvantaged group with a view to promoting social inclusion and addressing barriers to accessing services and support that could potentially meet needs.

The strategy is a high level document outlining the vision for services and the priorities and direction of travel up to 2013. It does not give detailed implementation plans. Additional individual Equalities Impact Assessments will need to be produced for specific service changes that result from implementation of the strategy.

The strategy also links with other strategic plans such as the Older People’s Well-being Strategy, the Primary Care Mental Health Strategy, Extra care Housing Strategy etc. Each of these strands of work will be producing Equalities Impact Assessments for any service changes they make. The OPMH strategy seeks to ensure that the needs of older people with mental health issues are taken account of in the development of these other areas of strategy development.

The scope of the strategy is broad and reflects the care pathways for dementia and functional mental health from the promotion of health and well-being right through to end of life care. It not only covers health and social care services but also encompasses support from communities and universal services that can be accessed by the broader population.

Summary of findings

It is important to note that any management information (activity, finance, performance) relating to older people with mental health needs (OPMH) who receive services is very difficult to obtain, particularly for Adult Services but also for the NHS. There are some specialist OPMH services but the vast majority of services and support is subsumed within mainly generic older people’s services and is difficult to quantify.

Therefore considering any subsets of data relating to further potentially disadvantaged groups is even more difficult.

Work is underway to identify how this can be improved but only limited data was available for use in developing this strategy.

A population needs analysis and data set was produced and includes prevalence data and data related to deprivation alongside some service data.

A broad range of engagement has been integral to development of the strategy, including:

Establishment of a multi-agency Steering Group
A consultation exercise undertaken by the Alzheimer’s Society on behalf of the Steering Group. 17 pre-existing groups of people who have an interest in older people’s mental health were visited. These included 2 groups from black and minority ethnic communities and one gay group.
2 workshops attended by representatives from a full range of stakeholders
Multi-agency and multi-professional workgroups, with representation from carers and the voluntary sector , who considered
Needs based care pathways for dementia and functional mental illness
The acute and community hospital experience
Needs analysis and performance measures
A formal 12 week consultation on the draft strategy

Specific issues were identified in relation to age related barriers to accessing service and barriers in relation to accessing some mainstream community services due to the additional presence of mental health need

The clear commissioning intention in this strategy is to work towards removing barriers to accessing services based on age or diagnosis for all older people with mental health needs

In addition great emphasis was placed on providing support to unpaid carers. The main vehicle for moving this agenda forward is the Carer’s Strategy, currently out for consultation.

The key priorities agreed in the strategy were determined by stakeholders and all consultations reinforced support for these.

Key priorities identified in the strategy focus on promoting social inclusion through the Older People’s Well-Being Strategy, Carer’s Strategy, self directed support agenda, opening out of day opportunities and promotion of awareness amongst the general public about dementia and depression in older age.

Summary of Recommendations

Work will commence in removing barriers to access related to age. The strategy makes this a strategic priority but does not detail how this will be done. This will form part of the implementation planning. The priority is to open up access to working age adult crisis response services for older people with functional MH needs and to ensure that the Primary Care Mental Health Strategy covers the needs of older people, particularly in terms of access to psychological therapies. The specialist mental health trusts will have responsibility for implementation and will need to consider Equalities Impact Assessments before any changes are made.

The strategy proposes that barriers to accessing mainstream community services should be removed and makes this a strategic priority but does not detail how this will be done. This will form part of the implementation planning. PCT provider services will have responsibility for implementation and will need to consider Equalities Impact Assessments before any changes are made.

The OPMH strategy gives priority to raising awareness and understanding in the general population regarding mental health issues for older people and reducing the stigma associated with such conditions. The profile of older people with mental health needs has been significantly raised during the development of this strategy and champions have been identified who will continue to promote this area. .

All linked strategies will identify the OPMH deliverables in their particular areas of work and these will be monitored at senior level (Joint Implementation Board)

A broad training strategy will be developed for health, social care, voluntary and private sectors to support the OPMH care pathways.

A service users and carers information project has been commissioned to develop local information resources linked with primary care services to improve access to appropriate support on diagnosis.

The care pathways in the strategy will be reviewed as part of implementation to ensure that needs related to spirituality and faith are identified.

In order to promote access to services for BME and other minority groups in the population of older people with mental health needs in Hampshire, one of the new Community Development Worker posts will be specifically targeted at support for OPMH.

Both Hampshire Adult Services and Hampshire PCT are keen to ensure that the high degree of engagement of stakeholders achieved in strategy development thus far is continued during the implementation phase. In particular noting the importance of service users, carers and voluntary sector engagement and ensuring continued representation in the governance arrangements.