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WRITTEN QUESTION TO THE MINISTER FOR HEALTH AND SOCIAL SERVICES BY DEPUTY D.J. DE SOUSA OF ST. HELIER
ANSWER TO BE TABLED ON TUESDAY 1st MARCH 2011
Question
"Would the Minister please inform members whether there have been any external and internal reviews in the area of mental health generally, what changes are being proposed, such as to the management structure of adult mental health and whether there are any staffing difficulties, such as in recruitment?"
Answer
The most significant general review impacting on mental health services has concerned the establishment of the Community & Social Services Directorate within Health and Social Services.
Following consultation with key managers and staff it has been decided that Community Services will organise its multidisciplinary teams within age group "divisions" i.e. Children's Services, Adults Services and Older People's Services.
The impact on Mental Health services is that Old Age Psychiatry will be managed within the Older Persons division, whereas Adult Mental Health services will be provided within the Adults Services Division.
Each of these divisions will be lead by a Service Director. Following a recent interview process it was decided not to fill these posts permanently at this stage and they will be re-advertised.
To ensure robust management arrangements are in place, Acting Director Appointments have been made to the Service Director Posts for Older People and Adults, and a Children's Lead Manager is in place from previous arrangements.
The Managing Director of Community and Social Services has a full complement of senior managers in place in adults and older people's mental health services, although their configuration has been changed at senior level because of the reorganisation of services into age groups. He anticipates being able to fill the permanent Service Director positions when they are re-advertised and, with current acting up arrangements, considers that he has appropriate management arrangements in place.
Children's Mental Health services provided through Child and Adolescent Mental Health Service (CAMHS) will be located within the Children's Division of the Community and Social Services Directorate. The Managing Director is giving consideration to what management capacity is required to fully support the clinical and professional work so well undertaken by this team.
A further significant area of consideration has been in the area of clinical advice and support to staff in Community and Social Services. It has been decided to appoint a Deputy Medical Director to enhance clinical input. Interviews for this post are being arranged.
Other reviews taking place within mental health services include a long term review of buildings provision focussed on re- providing services currently located on the St Saviour's site. Similarly consideration is being given to the relocation of mental health services provided within the General Hospital.
In addition to the above there are, throughout the year, reviews of individual cases and specific service areas are undertaken to provide organisational learning as to how best improve services in the future. From time to time external professional input is arranged to provide an extra perspective.
Areas which have received a priority focus include:
- Nurse Liaison Services
- Support to vulnerable adults, particularly those at risk of suicide.
- AIMs (Adult In-patient Mental Health Service) (2008/10). Peer review of Orchard House by Royal College of Psychiatrists and Royal College of Nursing.
- Nurse Staffing Review of inpatient areas (2007/8). Currently being reviewed and updated.
- Cooper 2010/11. Review of Community Forensic Service (Draft Report).
- National Memory Clinic Accreditation (2010) Royal College of Psychiatry.
There are long standing recruitment difficulties in Mental Health Services, particularly in relation to nurse staffing. This is part of a more general problem in relation to the recruitment and retention of nursing staff and is currently the subject of discussion with the States Employment Board.