Health chiefs explain why they can’t find £120,000 to fund Norfolk’s mental health support line

Mind support line. Ben Marshall, team leader. Picture: DENISE BRADLEY

Mind support line. Ben Marshall, team leader. Picture: DENISE BRADLEY - Credit: Copyright: Archant 2016

Four of Norfolk's Clinical Commissioning Groups (CCGs) have come in for repeated criticism in recent weeks for their failure to spend just £120,000 a year on a vital mental health support line. The potential loss of the service, run by the Norwich and Central Norfolk branch of Mind, has brought about our WeMind campaign, which argues it is desperately needed to save lives, especially when there is no suitable alternative. Today, Norwich, West, North and South Norfolk CCGs release an in-depth statement to explain their thinking.

OVERVIEW

Clinical Commissioning Groups in Norfolk are among the highest investors in mental health in England.

The NHS in Norfolk continues to invest in priority mental health services. However, there are many competing priorities for the money available.

The job of the county's CCGs is to plan and buy services for everyone in Norfolk and this sometimes involves making difficult decisions to ensure the NHS budget is spent in the most effective way possible.


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This is at a time when the NHS is facing very significant financial challenges – nationally and locally.

Tony Palframan is a GP in Poringland and is a member of South Norfolk Clinical Commissioning Group Governing Body.

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He said: 'Mental health care in Norfolk has always been a high priority.

'We are working with the Norfolk and Suffolk Foundation Trust (NSFT) to develop care for patients with mental ill health that is of the highest quality.'

NSFT is commissioned to provide mental health services to people who may be in crisis or experiencing clinical anxieties. Its services already include:

The Crisis Resolution Home Team has a 24/7 helpline for its patients;

The Norfolk and Waveney Wellbeing Service follows national best practice and has a helpline for patients within the service. It was launched in September 2015 and serves a much larger patient cohort than the earlier 'talking therapies' service for people with severe anxieties/depression;

Dedicated and additional interventions at A&E.

In addition there are a range of voluntary organisations that provide services and support to people with mental ill health, such as Samaritans, listed on NHS Choices.

Health and wellbeing is not just the business of the NHS. If the helpline run by MIND Norfolk is to be available, we invite partners to consider the responsibilities of the wider community in a broader context and look at other potential sources of funding.

BACKGROUND

MIND was given short-term, non-recurrent money from national mental health resilience funds to provide a telephone helpline across Norfolk from January 2015 to July 31, 2015.

This funding was always going to expire and the CCGs made clear in the spring of 2015 they could not find additional money to continue this helpline.

NSFT provided funding from July 31, 2015, to keep the service running to March 31, 2016. The Trust stated this could only be funded for a short period of time and no further funding was guaranteed.

The Trust recently wrote to MIND serving notice.

FINANCIAL PRESSURES

The CCGs are facing significant financial challenge and cannot justify spending additional money (recurrently) on a service that duplicates much of what already exists.

With the need to make collective efficiency savings of more than £40m to make the NHS budget meet demand in 2016/17, Norfolk CCGs would plainly be forced to reduce services elsewhere if they spent money on the helpline.

Nationally, the NHS is facing immense financial pressure. The national NHS savings requirement has been calculated as £22bn, to be delivered by 2020/21.

We are part of this. For local CCGs, every year there is a gap between our annual budgets and the increasing cost of providing healthcare to the people of Norfolk.

Efficiency savings are required to close this gap. This is not new – efficiencies have been 'business as usual' in the NHS for many years – delivering best value for money, within the resources we have available.

However the pressure is increasing:

- South Norfolk CCG is forecast to end 2015/16 with a planned £6m deficit having had to make £5.6m in QIPP (Quality, Innovation, Productivity and Prevention) savings. It must make £14m in QIPP savings in 2016/17;

- North Norfolk CCG is forecasting making nearly £8m savings in 2015/16. The savings requirement in 16/17 is £9.2m with no investment funding set aside;

- Norwich CCG is forecasting QIPP savings of £7.3m in 2015/16 and a further £9.7m required in 2016/17;

- West Norfolk CCG expects to make £5.5m in QIPP savings in 2015/16 and forecasts a further £10m required in 2016/17;

- NSFT is currently forecasting a £9.4m deficit.

CONTINUED INVESTMENT IN MENTAL HEALTH

Norfolk is already among the highest spenders on mental health in the country.

The CCGs have continued to invest in mental health:

- Increasing funding for mental health in line with Parity of Esteem guidance;

- About £2m planned for 2016/17 to transform the local child and adolescent mental health service. The CCGs expected additional funding for this but have since been informed they must fund it from their baseline allocation;

- Expanding an early intervention service for adults with psychosis in 2017/17 – subject to negotiations with NSFT;

- The new and successful Wellbeing Service which is helping thousands of local people deal with depression and anxieties since its launch in September 2015;

- Enhanced psychiatric support to A&E;

In 2014/15, Norfolk CCGs placed significant additional investments in NSFT in excess of £1.8m including – £557,000 non-recurrent funding to support the Child and Adolescent Mental Health Service Intensive Support Team; patient transport services and short-term beds to help reduce the number of out-of-county placements; £828,000 to help NSFT deal with increased pressures, and to invest in A&E Liaison and Gender Dysphoria services; and £478,000 recurrent funding for Section 136 suites and to expand NSFT's Attention Deficit Hyperactivity Disorder service.

The above list represents only some of the additional investments made in recent times.

The CCGs and NSFT remain committed to Parity of Esteem and provision of good mental health care – and will continue to work with the wider community to understand what should be core services and which services could be supported by the wider community.

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