National Priorities 2003-04
NHS Lothian – Mental
a. Title of Service
MENTAL HEALTH
b. The Local Position
b.i) Current Services
Over the past 5 years the mental health services in Lothian have moved from
being primarily hospital based to a position where they now have a strong
presence in the community with a Community Mental Health Team, jointly
staffed with our partners, in each LHCC and a growing range of community
based services. The plan over the next 3 – 5 years is to further develop the
community focus of the service whilst replacing the remaining very out-of-date
hospital premises with fit for purpose facilities.
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The Outline Business Case for the redevelopment of the Royal Edinburgh
Hospital has been approved and the redevelopment plans are now being
fully tested for Private Public Partnership before a Final Business Case is
submitted in early 2004.
Over £400,000 has been invested in the Child and Adolescent Mental
Health services, restoring and developing the service beyond its previous
capacity.
An action plan for developing Emergency and Crisis Care Services for
people with mental health problems is being prepared in consultation with
our planning partners.
A review of the Mental Health and Wellbeing Strategy and a study of the
mental health Acute Care Pathway are underway for completion in Autumn
2003.
This work includes a review of hospital and hospital bed
reconfiguration.
20 patients from the Orchard Clinic have already been discharged into the
Community in the first 12 months of the Clinic’s running, a very positive
reflection of the value of recent investment in community services and
supported accommodation.
A review of Psychological Therapies in Lothian is now underway to report
by the Autumn 2003
A practitioner network around young men's mental well being (Young
Guns) is being developed in Midlothian. The initiative will be rolled out to
Edinburgh in Spring 2003.
The establishment of Health and Wellbeing Partnership Groups in each
LHCC has made a significant improvement in the capacity of Primary Care
to promote better mental health and wellbeing.
National Priorities 2003-04
NHS Lothian – Mental
b.ii) Local Position in relation to National Targets
A PAF target for mental health services is to increase the proportion of total
spend on community services in relation to the total spend on Mental Health
services year on year. By the end of 2003/4 Lothian will achieve a further
increase in the spend on community services when the Bangour Village
Hospital site is closed and some further investment in Community Mental
Health services is made following the closure.
The second PAF target for mental health services is to reduce the number of
suicides amongst young people, especially young men. This corresponds
well with the themes for NHS Lothian’s work on mental health promotion
which are : young people’s mental health,
 suicide and self harm,
 stigma and discrimination.
c. Service Improvements Planned for 2003-04
 Implementing the next stage of the Mental Health Strategy :i. completing the closure of Bangour Village Hospital,
ii. progressing the redevelopment plans for the Royal Edinburgh Hospital,
iii. secure approval to the business case for the replacement of mental
health and older people’s services at Rosslynlee Hospital.
iv. secure approval to the business case for the replacement of mental
health and older people’s services at Herdmanflat Hospital.
 Complete the development of a comprehensive strategy for mental health
and wellbeing with our partners by Autumn 2003, taking into account the
range of needs not covered by the current strategy.
 Develop the Eating Disorders Service in accordance with the National
Framework, releasing funds by reducing referrals out-of-Lothian..
 Agree a strategy for the role and future shape of the delivery of
psychological therapies across all settings
 Secure the re-establishment of Independent Advocacy services at the
Royal Edinburgh Hospital.
 Establish Rehabilitation Services on a firm foundation with strong links to
the existing community services.Post-natal Depression – reach agreement
on the provision of specialist inpatient provision for mothers and babies
which is currently under discussion, linked to the review of hospital sites
and bed configuration.
 Single Sex Accommodation – a working group is currently considering how
best to meet this need within the existing buildings and will be reporting
with recommendations by mid /late April 2003. Action will be agreed on
receipt of the group’s recommendations.
National Priorities 2003-04
NHS Lothian – Mental
d. Planned Outcomes
 To open 20 places in the community for long-stay adult mental health
patients [and the reprovision of 30 NHS continuing care dementia beds] in
West Lothian enabling Bangour Village Hospital to be closed by Winter
2003
 To reduce the waiting time for referrals to the Child and Adolescent
Mental Health Services to a maximum of 12 weeks.
 Agree affordable plans to reshape Psychiatric Emergency Services and
the provision of Crisis Care services for the City of Eidinburgh in
collaboration with partner agencies. Agreed action plans to be in place by
March 2004.
 Production of arevised Mental Health and Wellbeing Strategy for Lothian
by late-2003/04 which sets out achievable action plans for the next 3 to 5
years for the promotion of mental health and wellbeing and the provision
of mental health services in the community, in primary care and in
hospital. This will developed jointly with our partners in the LAs. the
LHCCs. and the voluntary sector.
 A clear, agreed and achievable plan for the future of Psychological
Therapies which addresses the range of needs in acute and community
settings which is consistent with the wider mental health strategy. This
will include an Action Plan and proposed timescale setting out how
changes will be implemented.
 Clear agreed action by December 2003 in each local authority area to
meet the objectives of the national strategy, ‘Choose Life’.