Summary
We recognise the importance of mental health social care in the context of statutory responsibilities of councils and their key role as partners in integrated care boards.
With this in mind, in September 2023, we carried out an insight survey to find out about current practices and help shape and inform future support offered through Partners in Care and Health.
Directors of adult social services in each council were sent a link to the online questionnaire via email at the start of September 2023. A total of 71 completed surveys were received, giving a response rate of 46 per cent.
This report conveys the findings from the survey which cover three main aspects:
- engagement in the Community Mental Health Transformation Programme
- assessment and care planning - moving on from the Care Programme Approach (CPA)
- arrangements for the commissioning and delivery of adult mental health services.
The survey has allowed us to understand the progress and challenges being made by councils in the commissioning and delivery of adult mental health services, recognising areas of good practice that we can learn from and share.
These have been grouped into themes, each with recommendations for future work.
Recommendations
Community health transformation
While most councils feel involved as a valued partner in the community mental health transformation programme in their area, a significant number feel that their influence is limited and the impact on local mental health services is variable.
The importance of strong local programme management that enables engagement of key partners is highlighted, recognising the time and capacity that this requires.
Moving from the Care Programme Approach (CPA)
Most councils are involved in work to support a replacement for the Care Programme Approach (CPA), however confidence that local work is progressing in line with the five principles set out by NHS England is limited.
The extent to which the voice of adult social care can influence the work to move on from CPA is variable with 30 councils (42 per cent) responding that the voice of adult social care is not being heard at all.
Collaborative commissioning
Arrangements for collaborative or joint commissioning between councils and NHS commissioners is variable. This is particularly relevant in relation to the use of Section 75 agreements for pooled budgets and arrangements for S117 aftercare and support.
The availability of data to provide insight and assurance in relation to access activity, outcomes and experience is variable and an area where further guidance and sharing of good practice is sought. This is particularly relevant in the context of Care Quality Commission (CQC) assessment and assurance.
Collaboration in the delivery of mental health services
Many councils are actively reviewing their current arrangements to support collaboration in the delivery of adult mental health services with the NHS and VCSE sector. While there is no single model that is emerging, the focus for councils is ensuring effective alignment with the Care Act duties, improving professional practice and accountability and strengthening oversight and governance.
Sharing good practice and embedding sector led improvement practices
All councils can identify examples good practice to support the delivery of adult mental health services. This suggests that there is significant opportunity to share good practice and consider the role of regional and national learning networks with NHS and other partners.
There are key areas where councils have suggested additional sector led improvement support would be welcome, with key areas including commissioning, supporting professional development, and improving the availability and use of data to provide insight and assurance.