Mental health services across Greater Manchester are suffering from £90million of under-investment, according to a shocking report. The revelation follows an ‘independent diagnostic’ commissioned by Greater Manchester Integrated Care Board, which concluded the huge shortfall compared to elsewhere in the UK. Salford’s health and adults scrutiny panel are to be presented with an update on the Greater Manchester Mental Health Trust (GMMHT) ‘improvement plan’ tomorrow. Investment into the plan in its first year has reached £4.7m. This is after the trust was issued with a Section 29A warning notice by the Care Quality Commission in April 2022 when it was deemed ‘inadequate’ following an inspection. A further inspection in July this year also gave it an overall ‘inadaquate’ rating, although there were areas of the service which were upgraded to ‘requires improvement’. GMMHT has nearly 100,000 service users and has 6,700 staff. More than 8,000 students have used its recovery academy over the last 10 years. Councillors on the panel will be told: “An independent diagnostic commissioned by the Greater Manchester Integrated Care Board highlighted a £90m under-investment in mental health compared to national averages.” The report goes on: “The trust has a clear understanding of the scale and complexity of the key underlying issues and a commitment to deliver the improvements required within the system. “We are working to deliver fundamental changes to the safety culture, clinical and corporate governance assurance systems and leadership focus and visibility in the trust. “It is recognised that significant challenges remain regarding delivery against actions at the pace and scale and the environment is complex.” It said that the trust is continuing to receive support from the NHS England Intensive Support team via the Recovery Support Programme and is aiming to exit the programme by March 2025. The report continued: “The NHS England independent review is due to be published in January 2024 and the trust will respond accordingly to considering the outcome and any recommendations. “We will continue to work closely with NHS England regional and national teams to deliver against the exit criteria and the undertakings.” Meanwhile, the independent clinical review into what went wrong at Prestwich’s Edenfield Centre, where patients were subject to appalling abuse exposed by a BBC Panorama documentary, was concluded in September and the results are to be published at a date yet to be confirmed. Councillors will also be told of improvements to services in Salford, specifically relating to fire safety and ‘smoking cessation’ at the Meadowbrook mental health unit based at Salford Royal Hospital. Some £1.7m has also been invested at Meadowbrook to boost safety and sexual safety to single-gender adults of working age and psychiatric intensive care units. And a new ‘ligature process’ has been introduced and embedded across all wards and patient services, to the cut risk of patients self-harming. The report also said the length of stay and discharge performance of the Keats ward in Meadowbrook was now ‘the best in trust’. The Woodlands older adult inpatient facility in Little Hulton had been issued with a Section 29 Notice, but after the CQC returned earlier this year it was upgraded to ‘requires improvement’ and notice was not renewed. Management have also taken steps to improve their treatment of the workforce, with a ‘role model, coach, care compassionate leadership’ strategy, with ‘higher levels of compliance with mandatory training, supervision and appraisal’ reported. There is also an ‘enhanced shift pattern template’ on Meadowbrook and Woodlands wards, including increased night-time qualified nursing cover on all shifts on all wards. A ‘high number’ of newly qualified registered and international nurses had been attracted to Woodlands, despite a local and national shortage, the report said. However, Salford Royal has the busiest A&E department in GMMHT, and the demand on its mental health team ‘has increased’. Recruitment of social workers in the community mental health team (CMHT) continues to be a ‘challenge’. The report said: “Supporting patients in CMHT waiting for a care coordinator to be allocated, supporting them to wait well, is not optimal and carries risks. This process is in place pending a new model. “There are also challenges with attracting substantive medical/consultant staffing, with a high use of locums (temporary medics), and the appointment of a new medical director and a specific medical staffing and recruitment and retention strategy is a priority.” The report concludes: “The GMMHT improvement plan is being driven by a new, a temporary, but experience executive leadership team. “Greater Manchester-wide, the mental health system is under continued and sustained pressure and mental health is a theme in the health and social care system. “Mental heal services historically have experienced under investment – though better in Salford.”
