Issue - meetings

To consider the report

1.    To accept the report and support the department's plans to establish a new work model for the Mental Health Service.

2.     To ask the Cabinet Member for Adults, Health and Well-being to contact the Welsh Government's Health Minister to explain the intention to create a new work model and the reasons for that.

3.     A progress report and regular communication between the officers of the Department and the Care Scrutiny Committee on the development of the Mental Health Service was welcomed.

An update was provided on the Gwynedd Mental Health Service. The members were reminded by the Senior Safeguarding, Quality Assurance and Mental Health Manager that the Mental Health service had been an integrated team since 1996, and that the Health Board led on the service. It was detailed that the work was being guided by the Together for Mental Health Strategy, introduced by Welsh Government in order to improve the mental health provision available to support individuals in Wales.

It was explained that the service had been divided to offer support within primary services for low-level cases, and within secondary services for more intensive cases. It was confirmed that referrals were being received from GPs, before being scrutinised daily to consider if there was sufficient information to make a decision on suitability to receive a mental health assessment. It was noted that referrals were being referred back to the GPs with explanations, if they were not suitable to be referred to the relevant service.

It was explained that there were clear responsibilities within the partnership with the Health Board. As the Health Board led the service, the focus was on a diagnosis and medication on their behalf - the medical element. It was confirmed that Cyngor Gwynedd's role as a local authority was to focus on the social elements. It was noted that Cyngor Gwynedd also led on the work under the Mental Health Act 1983. It was emphasised that workers were the service's main resource as they offered therapy and support to individuals to overcome or cope with their illness.

It was confirmed that Cyngor Gwynedd employed staff in a number of different roles in order to offer this service, including:

·       2 Area Leaders (North and South Gwynedd)

·       12.5 Social Workers

·       9 Support Workers to work more intensively with individuals on care and treatment plans (with a financial contribution from the Health Board to employ them).

It was intended to re-model the current multi agency mental health scheme that Cyngor Gwynedd and Betsi Cadwaladr Health Board had, following a consultation with the Head of Adults, Health and Wellbeing Department, Senior Mental Health Manager and the two Area Leaders for Mental Health Services. It was highlighted that there was a need to review the role of the Support Worker within the service and a need to review out-of-county placements in order to ensure that we understood individuals' aspirations to return to the area or not.

It was reported that difficulties had arised across Gwynedd and the rest of Wales when local authorities collaborate with the Health Board in order to integrate Health and Social Care, including:

·       Lack of clarity about outcomes

·       Calling something a 'partnership' to make it sound better

·       Lack of clarity about organisational drivers

·       Lack of clarity about unstated motivators

·       Being unrealistic and over-ambitious;

·       Not enough attention to practical details.

It was confirmed that these general dangers were noted as core barriers by mental health leaders, which prevented them from realising their statutory duties effectively. It was  ...  view the full minutes text for item 7