The following is Macc’s understanding and observations on the current position. It is important to note that this is changing all the time.
Level of Cuts
The Manchester Mental Health and Social Care Trust is being forced to make cuts of £6.9m in 2015/16. This figure represents 7% of the Trust’s total £103m income. The figure is especially high due to £2m of the 2014/15 round of cuts not being achieved and therefore carried forward into this round.
£3.1m has been found through ‘conventional efficiency savings’ with the Trust’s corporate and management functions. Part of the remainder will come through a set of proposed ’service retractions’, meaning the total removal of certain services deemed ‘non-core’, which will achieve a further £1.5m of savings. This will leave £2.3m of savings still to be addressed.
Services affected
The Trust is proposing to withdraw the following services:
• Benchmark
• Creative Wellbeing – Start and Studio 1
• Green Wellbeing
• Individual Placement and Support Service (IPS)
• Perinatal liaison post
• The Psychosexual Service
• The Chronic Fatigue Service
• Specialist Affective Disorders Service
• Station Road Community Rehabilitation Scheme
The services facing possible closure cover a range of needs.
• Benchmark, and the Wellbeing services are practical or creative therapy-based sessions, such as gardening workshops, that support recovery and help people socialise and re-integrate while being overseen by professionals. These are positively received and obviously very valuable to many of their users who see them as route back into normal society without depending on medication.i
• IPS helps people recovering from mental health issues to get back into work by supplying ‘on the job’ support. Research has shown this method to be nearly twice as successful at getting people back into long term work as the standard ‘train then place’.ii
• Psychosexual and chronic fatigue services will be completely shut down as standalone services and there will be no replacements available, apart from the ‘urgent care pathway’
• that people presenting in a crisis will be assessed for. It is hard to see how the impact of this will not be damaging for some people in desperate need of help.
• The post of perinatal liaison nurse will be removed. A perinatal psychiatric service will remain, but it seems likely that without this specific post existing to offer advice on referrals, more new mothers with mental health issues will ‘slip through the net’ and not receive the help they need.
• The care home at Station Road, which consists of a main house and several supported tenancies in houses nearby, is currently run in partnership with Creative Support. As part of this round of cuts, the partnership will end and Trust staff will be withdrawn from the scheme. The Trust’s report states that redundancies are not expected due to redeployment. The report also mentions that Creative Support have recently notified the Trust that they have decided to withdraw their own services from the Station Road rehabilitation scheme and that they will be seeking to de-register the service with the CQC. Apparently, work has begun to establish whether the landlord, St Vincent`s Housing Association, is willing to take on the management of the home and therefore allow its inhabitant to remain.
Criticism of consultation process
During the Health Scrutiny Committee meeting on October 29th, both the representative of Manchester Users Network, and the Unison branch secretary representing the staff, spoke up to say that neither of their groups had been meaningfully involved in the consultations leading to the proposals for cuts. A member made the point that any initial savings achieved would be outweighed by the cost of acute services if people are in crisis at a later time.
Future of the Trust
As far back as January 2015, the Trust admitted that it was no longer viable as an independent financial organisation. It is now working with the NHS Trust Development Authority to identify how to continue the provision of mental health services in Manchester in a ‘sustainable’ form. This will almost certainly involve an expansion of the use of private contracts. Already, at the start of the latest financial year, the Trust was expecting to spend £3.5m placing patients into private beds.iii Discussions with the TDA have concluded that the required savings cannot be achieved through the disestablishment of the Trust alone.
Nuffield Health has today submitted a planning application for a £75m state-of-the-art hospital and wellbeing centre in Manchester city centre.iv
i www.manchestereveningnews.co.uk/news/greater-manchester-news/nhs-trust-axed-manchester-crisis-10348427
ii www.centreformentalhealth.org.uk/individual-placement-and-support
iii www.manchestereveningnews.co.uk/news/greater-manchester-news/nhs-bosses-meeting-decide-future-10468246
iv www.manchestereveningnews.co.uk/business/business-news/nuffield-health-submits-planning-application-10507699
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 Mental Health Cuts in Manchester Briefing 1.pdf | 385.01 KB |