To relieve pressure on GP surgeries and A&E, and provide addiction services, this manifesto calls for Brighton and Hove City Council and Clinical Commissioning Group (CCG) to set up a primary mental health service that provides peer support and mentoring for addicts, and addresses the co-determinants of health, namely community housing, employment, (including volunteering), detoxification, rehabilitation, and psycho-education teaching patients self care, so they need less public services. These new services should be provided at new Communal Living Centres, (such as Sussex House) and Community Care Centres (such as the shop at 187b Portland Rd Hove) which are mental health A&Es, open 24/7 to include crisis care. Providers should apply for a licence, (like taxi drivers) and compete in a free market for patients with other licencees, and be paid on outcome based contracts for services rendered at tariff rates in arrears on presentation of prescription vouchers signed by satisfied patients who would recommend the service to their friends and family. The system should be primary, to which anyone can self refer for immediate assessment, but referral for treatment should be not only by doctors, but also by social workers, occupational health staff, school and university health staff, prison governors, and others in a similar position. We estimate that every £1 invested in this system would save £7 in reduced public sector costs in primary and secondary care, benefits, and the criminal justice system. We recommend that a pilot trial for a year from Sept 2017-18 be commissioned for clusters 4 and 6 in Hove for 300 vulnerable patients annually at the above mentioned shop, which is estimated to cost £300,000pa from the Locally Commissioned Services Fund of £2.3mpa, and save £2 mpa.
Outcome of implementing this manifesto
a) Vulnerable people would be treated effectively to detox from addiction, and rehabilitate.
b) The Council’s mission to ‘end the need for rough sleeping by 2020’ would be fulfilled.
c) Doctors would be able to refer their mentally sick patients for effective treatment, so would not have to prescribe drugs inappropriately, burn out, and retire early, but continue their career.
d) Taxpayers money would be spent more wisely, and better value would be obtained.
e) Fulfilling careers and jobs would be created for holistic therapists, administrators and cooks in Communal Housing Centres and Community Care Centres.
f) Fulfilling jobs for volunteers would be created for vulnerable people, who could thereby build their self esteem, health and wellbeing.
g) By decommissioning addictive drugs which destroy communities, the CCG would meet their pledged commitment under the Social Value Act to increase social value in the city.