HWBB Update March 2022

Connecting Our City – Update

1. Since our last written update the Connecting our City working group has continued to meet every 8 weeks and the connecting our city steering group meets monthly to work on the detail of the York Community Mental Health Transformation Funding. Due to the well-established mental health partnership in York and the extent of the work that had been undertaken to define a vision and priorities for the City, York received a significant amount of pump prime moneys to enable us to start work early last year.

2. Progress on the pump priming moneys and year one allocations of the community mental health transformation moneys has been continuing at pace and details of this are included below.

3. York continues to be represented on the York and North Yorkshire Leadership Alliance which is leading on the Community Mental Health Transformation Moneys at a sub-regional level. York was allocated £430,000 in year one. Allocations for year 2 will be £940,059 (in addition to 15% cumulative contribution to programme costs which will cover the project management costs for City of York) and £1,161,771 (in addition to 15% contribution to programme costs) for year 3.

4. City of York Year 1 Priorities

Throughout a series of workshops and over a three year period, consistent themes have been identified as priorities for the City of York which have formed the basis of our community mental health transformation year 1 funding priorities:

· Development of mental health hubs

· Investment in the voluntary and community sector

· Culture Change

· Coproduction

· More link worker roles

· Whole system, whole person, whole life

5. Achievements since February 2021

a) Coproduction

The co-production network has grown in numbers, confidence and sense of purpose this year. Having a direct influence on the decision making of the Partnership helps drive it, as does the wide range of life experiences of the members. Anyone is welcome to drop in and out, it reaches those in primary care, secondary care, no care at all and of course those who work with them or just have an interest.

Difficult discussions are had in a supportive, understanding arena, such as how to move away from diagnosis centred conversations and think broadly about what can help everyone to lead their best possible life. The January discussion on how to best spend the money allocated to cultural change was far reaching and settled on finding a way to change attitudes and reduce barriers when trying to access primary care.

· From February 2021 monthly coproduction network meetings established. 11 meetings, regularly attended by 12-15 people (growing each time). 40% Lived Experience (and carers) establishing purpose/aims and ground rules. Establishing speaker briefs and ground rules to support people with Lived experience.

· Safety policy and Guide Top/Top Tip of Co-Production being created by Co-Production Network. 

· March 2021 Expression of interest for a voluntary organisation to host a coproduction champion

· September 2021 Coproduction champion in post at York CVS – 20 one to one meets and multiple team/zoom meetings

· December 2021 Weekly coproduction drop ins at Priory Street

· January 2022 Weekly drop in at Clarence Street added

· Lived experience involvement across workstreams and working groups

· Partnerships being developed across the City. Including City of York Council, York MIND, CAMHS, YSJ Converge, Carers Centre, York Cares, CAMHS, The Retreat, York Ending Stigma(Previously TIME TO CHANGE) and Multiple Complex Needs Network.

b) Investment in the voluntary and community sector

· Investment in social prescriber roles at Foss Park and as part of hub developments

· Coproduction champion based in the VCS

· Peer Support Project – York Mind

· Peer Carer Support – York Carers Centre

· VCSE Alliance Development Lead role to be recruited shortly by York Mind

· Initial investment of £125,000 into local VCSE activities – grant fund to be established by York CVS over the next few months (recurring over 3 years)

· Financial recovery coach based with Peasholme Charity working out of 30 Clarence Street

c) Pathway to Recovery Project

· Team of social workers, social prescriber based at Foss Park since June 2021

· Peer support and peer carer support established and linked to the project

· Provide placed based early help (to reduce admission length, and/or risk of re-admission).

· Connect people with their communities as part of a strength based community asset model to maximise wellbeing and recovery to those most in need.

· Team has worked with 77 people to December 2021

· Financial Capability Coach to be recruited by Peasholme Charity to support the team and link with 30 Clarence Street – interim provision of one day per week in place from February 2022

· Developing links to 30 Clarence Street to encourage a ‘step down’ approach from Foss Park. Activities and resources available within 30 Clarence Street are being developed including a series of Converge taster sessions.

d) Eating Disorder Provision

· NY&Y Eating Disorder Workshop November 2021 – 38 attendees.

· Beat (national eating disorder charity) commissioned to provide:

- 35 waiting list support for adults

- 35 early intervention support for adults

- 40 one to one support for parents/carers

- 64 training/workshop for parents/carers

- Additional provision for 18-25 year olds across Vale of York with a focus on ARFID

· Successful City of York working group held January 2022 to consider whole system plan for future provision. Evolve Community Eating Disorder Service attended to talk about the provision in Hull.

e) Mental Health Hub Development

· City of York hub development workshop held October 2021

· Discussions with Innovation Unit to support the prototyping of a hub model for York, develop system leadership and integrate secondary care.

· Work to begin the design phase of a hub model in York to begin April 2022

· Re-commissioning of the Haven in progress and has been linked to the connecting our city developments

· Reimagining 30 Clarence Street underway to increase the support and activities available at Clarence Street

· Additional investment and development of crisis support

6. Year one Allocation Detail

Year One Allocations: Description	Year 1 Transformation Funding	Additional Funding
1.1 Whole system approach/programme coordination
Project management roles – recruitment of Project Manager and Project Assistant	£0	£100,000
1.2 Co-production Infrastructure
Coproduction champion role employed by York CVS	£0	£40,000
Budget to support involvement with meetings/forums/panels etc	£0	£10,000
1.3 Development of ‘Trieste’ style mental health hubs
Hub development support – Commissioning the Innovation Unit to support on three strands of work: system leadership; prototyping and growing a new mental health hub for York and integrating secondary care into the new model.	£49,900	£120,000
Year 1 Eating Disorder Provision - commissioning a range of packages from Beat (national eating disorder charity) to support families and carers, people awaiting a specialist service and those not currently eligible for specialist support. TBC YSJ DBT group work programme.	£70,000	£85,000
Hub multi agency staffing base to support prototype model including social prescribing and  peer support	£90,000
1.4 Pathway to Recovery Project – team of social workers, social prescriber, peer support and peer carer support. Based at Foss Park hospital working with people on admission to ensure a planned and supported discharge linking to community based support.
Social work and social prescriber roles	£0	£201,000
Peer Support	£0	£50,000
Peer Carer Support	£0	£50,000
1.5 Investment in VCSE to build capacity and enhance and develop community resources and support.
Funding for VCSE sector – grant fund for local VCSE orgs to meet the sector’s ability to co-produce the support and activities people want in their communities and provide continuation funding for support that works. Focus on inequalities.	£125,000
VCSE Alliance Lead post (inc admin support) to provide development support and to capacity build within the sector and to work to evolve this into a VCSE alliance model with a view to mainstreaming into commissioning processes after year 3.	£55,000
1.5 Community Conversations
Skilling up local community leaders, community roles such as local shops, hairdressers, pharmacies in MECC, MHFA, and ASSIST. To promote positive conversations about mental health within communities.	£4,000	£4000
1.6 Culture change programme
Working collaboratively with the coproduction network, the MCN network cultural values project and the people on the ground network. Planning a range of approaches to develop shared culture across the workforce.	£5,000	£10,000
1.7 Evaluation - Application has been submitted to host a PhD student to support the evaluation of the programme. This will be match funded by York St John. We are also working alongside Converge to support in depth evaluation of the pathway to recovery pilot.	£14,000
Total	£412,990	£400,000

7. What’s Next

· Focus on services for people with complex needs associated with the diagnosis of a ‘personality disorder’

· Detailed development work on eating disorder provision across the Vale of York

· Prototyping a hub model for York – design phase to begin shortly alongside the Innovation Unit

· Grant fund to go live for the VCSE

· Refine priorities for years 2 and 3

· Evaluation – how will we know if we have made a difference?

8. Challenges

Whilst the Connecting our City partnership has made huge progress in a short space of time, there still remain some significant challenges for which we request support from the Board:

- The commitment for this project from the outset has been for sustainable funding of at least 3 years, particularly for the VCSE. We urgently require confirmation of the continuation of all existing investments in order to allow contracts to be issued/extended. Lack of this confirmation poses a significant risk to the project and to posts and projects.

- The progress made, has been as a result of having project management capacity to drive it forward. The result of this progress is that we now have a significant and highly complex programme of work which cuts across commissioning, partnership working, service design, coproduction and culture/system change. In order for this to be sustained, additional programme support is required on a sustainable basis.

- City of York have taken a different approach to the transformation work from the rest of North Yorkshire that has widespread support from across the system. However true system change takes time and takes courage. This project requires strategic leadership support from across the system and for this to translate down to senior and middle managers across partner organisations. We would request the establishment of a strategic leadership group for York to facilitate a way for barriers and challenges to be addressed. The establishment of this group will be supported by the Innovation Unit.

Kate Helme

Community Mental Health Project Manager, City of York Council