The NHS in Wiltshire: local mental health service under more pressure to improve
It has just been revealed that the three Wiltshire Clinical Commissioning Groups (CCGs) have voted to serve a ‘performance notice’ on the Avon and Wiltshire Mental Health Partnership Trust (AWP). This notice would mean that if AWP’s service for patients in Wiltshire did not improve, steps would have to be taken to find another provider.
The decision on the order was made at meetings of the new CCGs in February – the CCGs are now working alongside NHS Wiltshire in commissioning primary care services for the county. All three CCGs (this was before they merged into one CCG for all of Wiltshire) were unanimous that something had to be done about the provision of mental health patients.
The meeting of the North East Wiltshire CCG (NEW) on February 21 took into consideration the impact the notice might have on AWP’s application to become a Foundation Trust. But they decided that as the performance targets set by Wiltshire NHS had not been met it was right to issue the notice – “the safety of patients was paramount”.
However, NHS Wiltshire are not able to serve such a notice. This can only be done by South Gloucestershire PCT who hold the contract with AWP on behalf of all the client PCTs. And South Gloucestershire are now in discussions to see whether they can work out a ‘remedial action plan’ to improve AWP’s service.
It is not clear whether the CCGs’ vote was relayed to AWP and so may have influenced the decision of AWP’s Chairman, Felicity Longshaw to resign on April 25, and for the Chief Executive to take open-ended leave. AWP is commissioned by six primary care trusts to provide mental health services for adults and older people over a large area of the south-west – and it runs mental health teams for adults out of Savernake Hospital.
At NHS Wiltshire’s board meeting on May 23, it was made clear that contact with AWP’s new management team had been established and that GP’s leading on mental health for the Wiltshire CCG were working with AWP to improve its services.
The board were told that there had been ‘anecdotal evidence of improvements’ under the new management team – there was even talk of ‘green shoots’ of improvement. The same doubts and evidence of some improvement came from doctors from the Bath and North East Somerset PCT (BANES) which has now merged with Wiltshire NHS as required under the government’s reforms of the NHS.
In 2011-2012 Wiltshire NHS spent £33,719,312 and BANES spent £13,495,00 buying services from AWP. In 2010-2011 Bristol PCT spent £45 million with AWP and have become so unhappy with AWP’s service that they are preparing to tender for a new city-wide mental service.
In mid-June Bristol PCT starts a three month long consultation process with stakeholders and wants the new mental health service to be operational by April 2014.
In case it becomes necessary, NHS Wiltshire are beginning to plan for a procurement process, is working with AWP’s other commissioners and starting to engage with stakeholders. Mental health has appeared as a new item on NHS Wiltshire’s risk register.