Parity of Esteem a Chief Officers Perspective Nigel Gray Chief Officer Together we’re better

What do I see? Health and Social Care Integration, Better Care Funds and the big ticket items do not automatically included Mental Health… but we are getting there. A default position to Urgent Care services when Planned Care could be.. Well more planned! There is some really good stuff going on but we don’t always share it! We are not there yet!

Commissioning Services and Parity of Esteem Treating mental health equally to physical health – Equal Access to the most effective and safest care and treatment - embedding parity of esteem requirement in all major contracts – Equal efforts to improve the quality of care - integrated improvement programmes (urgent care in mental health, quality premiums) – Equal high aspirations for service users - shared city wide vision describing aspirations, as described by people who access services – Equal status in the measurement of health outcomes - quality premium City wide approach (3 CCG, unit of planning) on parity of esteem Reflected in JHWS and Lead CCG objectives

Leeds Mental Health Framework 5 year Framework developed by a citywide MH Partnership Board - representation from Leeds City Council, Service providers, people who access services, Public Health and CCGs. The Framework Vision - Leeds is a city that values people’s mental wellbeing equally to their physical health 5 Outcomes – one of which is Mental health and physical health services will be better integrated Commitment to PoE and Framework Vision in all contracts across acute, community and MH.

CCGs Strategic Actions 14/15 Agreement to use key cross cutting issues in RCPsych Report 2013 “Whole-person care: from rhetoric to reality..” to guide our local priorities: Assess local position / what’s our baseline? Agree local action plan and progress measures. Promote issue of parity in service developments and assess proposals against parity principles Develop clinical champion role across CCGs to raise awareness and training opportunities

Parity of Esteem Programme Leeds CCGs 2014/15 and Beyond Develop city wide high profile mental health information for public and professionals to improve patient pathways. Improve mental health awareness in primary care - identify training needs for primary care clinicians, improve and extend psychiatric liaison role to primary care. Improve physical health of people with mental health issues – 2 x CQUIN with MH provider LYPFT on smoking cessation and nutritional advice, improved follow up support for people on anti psychotic medication supported in primary care.

Parity of Esteem Programme Leeds CCGs 2014/15 and Beyond Investment in Mental Health – maintain levels of investment with statutory provider, increased investment in third sector provision, re-invested MH contract tariff deflator 0.3% to achieve parity with Acute contract (targeted to quality improvement), exploring integration of MH budget with Local Authority to maximise benefit of personal budgets. Improve Integration of MH in long term conditions pathways – agree MH training for clinicians working with LTC, KPI for LYPFT on discharge information (incl physical health data) back to primary care.

Opportunities Working Collaboratively – Integrating MH support with PC and Chronic Disease Management, MH Partnership Board building relationships between CCGs and LA and those who access services. Personal health budgets and pooled budgets Leeds Pioneer Status for integration…including Mental Health? Sharing Expertise – recognising where others may be better placed or more cost effective in delivery – facilitating partnerships between secondary care and third sector (rehab pathway work). Exploring prime contractor models and capacity building in third sector

National/Regional/Sub Regional Support A National CQUIN? Equal application of Tariff Deflators? 10 High Impact Changes for parity? Promotion to GPs and recognition in all directly commissioned services Joined up approach with specialised services Calls for parity of esteem from outside of the Mental Health System?

Thank you and any questions or comments?