1. Jonathan Lloyd Director of Strategic Delivery Birmingham and Solihull MH Foundation Trust

2. National perspective Parliament Secretary of State for Health/DH Strategic Health Authorities NHS Trusts PCT/Care Trusts Independent Sector Foundation Trusts Monitor

3. National Perspective Based on top down mechanisms NSF, NICE targets and performance management processes Period of extra spending on staff capacity and equipment

4. National Perspective Based on a quasi managed market Demand side: patient choice and commissioning Supply side: Foundation Trusts and IS Incentives: Payment by Results (related to activity) Regulation: Monitor and Care Quality Commission

5. National Perspective Moving from input to outcome measures Emphasis on strengthening of commissioning Greater choice Clinical Leadership Payment of services based on quality

6. Regional Perspective Completing the work on the MH National Service Frameworks Improving inpatient care for people with mental health problems Doing more to promote social inclusion and pathways out of care (employment) More work to prevent suicides Better prison mental health services Better integration between mental health services and alcohol and substance-misuse services Mental health promotion and prevention – with an emphasis on self-help.

7. Local Perspective Population is 1.2million Single population is high Higher levels of deprivation against England average Less mobile population than England average Inflow of workers from the Black Country Reliance on higher qualified labour from outside of the region (Birmingham only) Unemployment rates significantly higher than England (high levels in the Pakistani population)

8. Local Perspective Population to likely to increase by 2025 Higher increases in the population 20-35 age group and 60-65 age group by 2025 Increase in the proportion of Asian and Black population by 2025 Increase in the skilled population being imported from the Sub regions

9. Local Perspective Higher levels of depression in South Birmingham Higher levels of dementia in South Birmingham and Heart of Birmingham Higher levels of schizophrenia in BEN, HoB Bi polar disorder high in BEN, HoB, and Solihull.

10. BSMHFT Perspective One of the largest mental health Trusts in the UK Area: 172 square miles Employ over 3,900 staff We train 20% of the Country’s Mental Health nurses Very good reputation in specialist MH Services Achieving Foundation Trust status (only 2 MH Trusts in the West Midlands to achieve this) 3 New Hospitals delivering 21 st Century MH Care Strong R&D base – clinical expertise nationally recognised Diversity initiatives

11. BSMHFT Delivery Total income - £207m Contact with 50,000 people a year Operating out of 106 sites 779 inpatient beds 53 wards 130 Clinical teams

12. Funding Our major sources of funding are provided by our five Primary Care Trusts (PCTs) and the West Midlands Specialised Services Agency – in total 80% of our total income. National Commissioning Group – Forensic CAHMS

13. Services Community Mental Health Teams Assertive Outreach Teams Crisis Resolution/Home Treatment Teams Rehabilitation & Recovery Teams Liaison Psychiatry Teams Inpatient services Early Intervention Teams Primary Care Mental Health teams Forensic medium secure Personality Disorder Services

14. Services – continued Working Age Dementia Team Drug Intervention Programmes Prison Mental Health Services Prison Detox services Community Alcohol Team Deaf Services Neuropsychiatry services Mother and Baby services Eating Disorder services Mental Health Intensive Care Units

15. Challenges Responsive to Service User needs Enhance the quality of services (and measure quality consistently) Use of FT freedoms and autonomy Interface with primary care Engagement with FT membership Relationship with GPs and PCTs Interface with IS and Voluntary Sector

16. Initiatives Developing our Forensic Services Developing our Specialty Services Implement the Older Adult Strategy Developing Community and Psychological Therapies Implementing operational changes to reflect the functionalised delivery of care Reconfiguration of Estate/Inpatient Services Developing minimum standards of care

17. QUESTIONS ??