Leicester City CCG
4th Floor, St John’s House30 East Street
Leicester, LE1 6NB
15/08/2021
RE: Step up to Great Mental Health in Leicester
I write in response to the consultation being conducted by the three NHS clinical commissioning groups covering Leicester, Leicestershire and Rutland entitled Step Up to Great Mental Health in Leicester. It has long been clear that Leicester’s adult mental health services require investment and improvement
Since 2010, mental health funding nationally has been cut, the number of mental health nurses fell by 5,545 by 2017 and in 2021 there is still 2,200 fewer mental health nurses and remaining mental health budgets have been raided to plug holes elsewhere in the NHS In the three CCGs’ own Pre-Consultation Business Case, the evidence has indicated that only 14% of adults surveyed felt they were provided with the right response when in crisis. This means that a staggering 86% are not receiving the right mental health support
Over the past year, COVID-19 and Leicester’s extended lockdowns have shone a light on the inadequacies of mental health provision in constituencies like mine. During the pandemic, mental health has been an issue of major concern, which many residents of Leicester East have raised with me. I therefore support the three CCGs prioritising this issue and working in partnership to address the apparent dissatisfaction with existing services. My response to the consultation, as set out in the attached report, highlights some concerns and makes a number of suggestions, which I hope the three CCGs will address as they move forward with the process.
With regards to the proposals highlighted in the consultation document, the introduction of the Central Access Point phoneline, as a means of providing readily available help and advice, as well as other additional community mental health services during the pandemic have been welcome initiatives in this challenging time.
Nevertheless, I have concerns regarding the lack of a clear evidential justification for several of the proposals outlined in the consultation document. I would have expected to see an evaluation of the likely success of the proposed initiatives based on reports of the performance of similar schemes already implemented elsewhere in the UK. For instance, three Crisis Cafes already operate in Leicester and I would have appreciated seeing more detail regarding how their performance has influenced the three CCGs’ proposal to expand their numbers to 25. I would also have expected to see more evidence regarding the effectiveness of the new services that have already been tested during the pandemic, such
For casework please email: claudia.webbe.mp@parliament.uk Twitter: @claudiawebbe www.facebook.com/claudiaforLE www.claudiawebbe.org
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as data relating to the usage of the triage car service. Furthermore, it is unclear why Acute Day Units, which have a comparatively strong reputation for success in treating conditions of mental ill health, have not been considered in the proposals.i
I also have concerns regarding the extent to which the proposals outlined in the consultation have been co-designed with staff, service users and stakeholders. In the Pre-Consultation Business Case, the three CCGs claim that its proposals have been co-designed by staff, service users and stakeholders. However, the consultation and its supporting documents provide little evidence to substantiate this claim.
Furthermore, I have considerable concerns over the decision to effectively disband mental health services at the Leicester General Hospital, including the Personality Disorder Service, the Psycho-Oncology Service and the Liaison Psychiatry Service, as these services address specific needs that may not be met, at least to the same extent, by the proposed replacement services, such as Community Treatment and Recovery Teams. Finally, I note that the future of the Leicester General Hospital site has been decided through the separate Building Better Hospitals consultation, which has already concluded. I am concerned that this may risk prejudging the outcome of some elements of the present Step Up to Great Mental Health in Leicester consultation. Specifically, it may not be possible to provide the services that are currently administered on site at Leicester General Hospital, once the site has been downgraded.
I therefore require some reassurance that the proposed changes to mental health services are primarily a response to patient need, as opposed to a means of managing a potential reduction in capacity comparative to population resulting from the Building Better Hospitals plan. In particular, I would be grateful if you would:
• Explain the decision to consider the future service provision and hospital facilities in separate consultation
• Provide the evidential basis for the consultation document’s assertion that its proposals will improve the provision of mental health services in Leicester.
• Explain why the introduction of more Acute Day Units is not being considered as part of this consultation.
• Explain what measures, beyond the present consultation, the CCGs are putting in place to ensure patient input into the co-design of proposals for future services.
• Explain the rationale and evidential basis for the proposed disbanding of the Liaison Psychiatry, Psycho-Oncology and Personality Disorder Services in favour of apparently less “intensive” treatment within the community
Thank you for taking the time to consider this important matter. I look forward to your response and consultation outcomes
Yours sincerely,
Claudia Webbe MP Member of Parliament for Leicester Easti https://www.medrxiv.org/content/10.1101/2021.07.08.21259617v1.full.pdf
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