The essential stories and opinion in health today

MCP milestone

The race to create the first multispecialty community provider has begun and Dudley CCG is currently the leading player.

This week it took the first step in procuring the contract for its MCP with the publication of a prior information notice, and market engagement event will follow in January.

Most interestingly, a document seen by HSJ suggests the provider could hold the budget for adult social care services in Dudley.

The inclusion of adult social care services has been debated by the CCG and borough council for a few months but a line the CCG has been consistent on is the inclusion of GPs within the MCP. Chief officer Paul Maubach made it clear the MCP cannot work without primary care and the event in January would be an opportunity for providers to engage with Dudley’s GPs.

In July, the Dudley Group Foundation Trust expressed its concerns that putting the MCP contract out to tender would present huge financial risks to its future.

The CCG has responded by saying it is the trust’s responsibility to fully explain the risks involved and it is not its problem if these haven’t been fully communicated to them before the procurement finishes next year.

New targets

NHS trusts will soon have to report how quickly they are treating patients experiencing mental health crises in A&E and hospitals.

New guidance from NHS England sets out how acute and mental health trust should set up liaison psychiatry teams and meet the new emergency access and waiting time target from April 2017.

Liaison psychiatry is a key part of the Five Year Forward View for Mental Health, with all hospitals having to have a team by 2020-21, with at least 50 per cent of teams working 24/7.

The new targets demand that patients in A&E suffering an urgent or emergency mental health crisis should be seen by the liaison psychiatry team within an hour. Emergency patients should then have a care package within four hours, while urgent cases should have one within 24 hours.

The guidance follows NHS England announcing a new £30m pot for regions to bid for cash to expand or create liaison psychiatry teams as part of £120m of investment planned for mental health services.

But while the new guidance explicitly explains how teams should be set up, managed and the target achieved, it leaves a few unanswered questions – the most notable being what proportion of patients are expected to be treated within the new time limits?

It is clear that NHS England wants commissioners to be responsible for making sure each hospital has a liaison psychiatry team, but it leaves open whether this is provided by mental health or acute trusts.

So who holds responsibility for these teams and who will be rapped across the knuckles if targets are missed: the hospital, the mental health trust or the commissioners?