UNISON Manchester Community and Mental Health branch
We are sending this information to correct errors in the Consultation Paper. This is not our response to the consultation – we will send that at a later date.
There are a number of factual errors and partial facts and important omissions in the document. We are very concerned that by using inaccurate information, the Trust is presenting a false impression of these services and what the impact will be if they close. We do not know why inaccurate information has been presented or where this inaccurate information came from. We are concerned that staff were not asked to provide information, yet they are the people with accurate and up-to-date information about the services and service users.
We request that these inaccuracies are corrected and that a revised consultation document is produced.
We also request that these amendments are prominently displayed on the Trust’s and the CCG’s websites alongside the consultation documents, so that anyone who is responding to the consultation will be aware that the document has been amended.
The issue of income generation not being included was answered by Carol Harris as being because in the cases of Benchmark and SSAD their income did not fully cover their expenditure. That is not the point. Expenditure is given in the consultation paper. It should indicate to what extent this is offset by income.
Specific inaccuracies are detailed below.
The information omits to say that Benchmark generates income. In 2010 this actually exceeded the current cost of the service, bringing in £88,000.
The information omits to say that £14,000 was spent on assessing the viability of turning Benchmark into a social firm, but in 2012 the Trust stopped the process, despite £35,000 social enterprise investment having been secured to move Benchmark into an external organisation.
The information omits to say that 15 of the current service users of Benchmark receive social wages under the supported permitted earnings rules. There is no mention of the legal position of these service users, whether they are counted as employees of the Trust, and whether they will be entitled to redundancy payments or notice periods if Benchmark is closed.
The figures given for current service users gives only just over one-third of the current actual users.
The 14 people referred to are presumably from the legacy group (8) and the recovery pathways course (6). But Green Wellbeing also runs three sessions a week for Park House acute ward in-patients, averaging 15 people over the three sessions. There is also one session a week for Acacia Ward, with an average of 4 or 5 people per week. There is also a weekly session for 4 service users from Young Onset Dementia. That makes a current total of 37 service users.
Specialist Affective Disorders (SADD)
This service title is incorrect. It should be Specialist Service for Affective Disorders (SSAD).
The information implies that referrals can only be made from secondary care staff. This is not true. SSAD does take referrals from GPs.
The information about current service users and those on waiting lists is wrong. In early November 2015 the active waiting list had 61 people on it, which included 16 people waiting for PE (therapy) referred in 2015.
The information implies that having a care coordinator or another professional involved in their care will be sufficient replacement for SSAD. This is not true. The patients have been under routine services for an average of 18 years and have not got better – that is why they are referred to SSAD, as a tertiary service for treatment resistance. They are the most unwell with the highest financial burden.
The information completely omits to say that SSAD a) generates income for the Trust, and b) has evidence that the service saves a significant amount of money for the Trust, and c) that the Trust will have to pay to refer patients to the remaining two specialist services out of area.
- Out of area patients bring income into the Trust. Based on 25 out of area referrals a year, at a cost of £2,142 per patient (total for assessment and follow-up), this generates £53,550 per year.
SSAD has received research income in the past. In October 2015, £96,000 could have been received for a research project, but this could not go ahead because the service could not commit to the 18 months of a trial of an anti-depressant drug because of the threat of closure. A further amount of £7,500 for specialist group psychoeducation has also been lost for the same reason.
- SSAD research evidence shows that in-patient admissions are significantly reduced. In the 12 months before receiving PE, the therapy aspect of the service, there were 22 admissions; in the 12 months after, just 9 admissions. At an estimated cost of £1,000 per day for an in-patient, and given that these are usually long admissions, it is likely the cost of in-patient care for these patients will be more than the total cost of the SSAD.
- In 2014/15 there were 29 new patients and 17 follow ups from It is estimated that their referral to one of the other specialist services out of area could be at least £77,000 (£65,000 for new appointments, £12,000 for follow up).
The figures for current service users and the waiting list are wrong. There were 79 current service users, and 186 on the waiting list at the end of October 2015. The service receives over 200 referrals per year. The total salary for the one whole time equivalent staff (3 part-time staff) Is £47,000, so it is not clear how the cost of the service is as stated, £99,000, since there would appear to be few costs other than the salaries. Indeed, the original paper to the Health Scrutiny Committee stated that the service had 3 staff, 1.2 wte, and cost £99,000. The number of staff in total has been corrected to 3 staff, 1.0 wte, but the cost remains £99,000. There needs to be clarification as to how the costing for the service has been calculated.