Talks are already under way to create more pilot sites to take on new commissioning powers and develop models of care for tertiary mental health services, HSJ can reveal.

Last month NHS England announced six regions would be given devolved commissioning powers for low and medium secure adult mental health services, and children and adolescent mental health services (see box).

The six sites have been drawing up plans to implement new care models across their regions and NHS England has set aside £1.8m to help fund them.

National mental health director Claire Murdoch told HSJ discussions have already started with other areas that were unsuccessful during the first round of bidding.

She said: “[Former Oxleas Foundation Trust chief executive] Stephen Firn and colleagues have identified the ones that were strong, perhaps not in the first wave, and have started talks with them in preparation to be in wave two.

“We absolutely hope to cover more areas of the country if this is successful.

“We don’t see this as a long, strung out affair. We want to use the first wave to show we can sensibly make the changes to a co-commissioning, providers-led series of innovations. But we want waves two and three in the blocks and good to go over the next few months.”

The pilot announcement was part of the publication of Implementing the Five Year Forward View for Mental Health.

Sites piloting new mental healthcare models

CAMHS

  • West London: West London Mental Health Trust (with Central and North West London FT, Priory and Like Minded)
  • North east and north Yorkshire: Tees, Esk and Wear Valley FT

Secure adult services

  • West Midlands: Birmingham and Solihull Mental Health FT (with South Staffordshire and Shropshire FT and St Andrew’s)
  • Oxford and Thames Valley: Oxford Health FT (with Berkshire FT, Dorset FT, CNWL, Solent Trust, Southern Health Trust)
  • South London Partnership: South London and Maudsley FT, Oxleas FT, South West London and St George’s Trust
  • South West: Devon Partnership Trust (with Avon and Wiltshire FT, Cornwall FT, Dorset FT, 2gether FT, Cygnet, Partnerships in Care, Livewell)

HSJ understands the sites are still hammering out the details of their plans, but Ms Murdoch said they are expected to go live by October.

She said: “We are hoping that in October they can go live, that’s a really challenging timescale. Colleagues are working really hard both in the system and at NHS England to make sure the information and support is there.”

One of the pilots, the West Midlands Partnership, is expecting to take control of a budget of £100m-£120m to run low and medium secure adult mental health services for 600 patients across the region.

Birmingham and Solihull FT’s clinical director for secure services, Jeremy Kenney-Herbert, said forensic outreach teams in the community will be strengthened and expanded to allow more patients to be treated at home.

He said the teams would be extended across the West Midlands for the first time, which will free up capacity bring back patients treated away from their local area.

He added: “Any savings will be reinvested in the pathway. One way we are looking to do that is to ensure forensic outreach and common forensic services are in keeping across the West Midlands, obviously taking into account local need.

“Forensic outreach is not available in all parts of the West Midlands – we would like to develop that. We will make sure there’s a very strong governance structure.”

Dr Kenney-Herbert said part of the work will involve working with housing support organisations in the private and voluntary sectors to provide supported accommodation to help patients be discharged from secure facilities.

He added: “We really need to enhance their recovery and make sure the type of housing and support they need, whether it is to be us or other services in the future, in the long term minimises [out of area treatments].

“We would like to be able to offer a better facilitation of care in the community.

”We are looking at people out of area now: do they need to be in secure care or are they still there because the right resource hasn’t been directed towards them?”

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