9.99 Fixing primary care by co-commissioning mental health services with patients and communities overseen by the Health and Wellbeing Board (HWB)               16.10.15

Paper for the Brighton and Hove CCG Board and HWB
By John Kapp, 22, Saxon Rd Hove BN3 4LE 01273 417997,, company secretary of Social Enterprise Complementary Therapy Company (SECTCo) References thus (9.76) are to my papers published on ..

1 Abstract
The crisis in primary care is caused by the increasing numbers of patients presenting with mental health problems, who tend to be given drugs against NICE guidelines, which make them worse with side effects, so they keep coming back as if in a revolving door. Parliament placed the responsibility for solving this crisis with the Health and Wellbeing Boards, in power sharing agreements with the 30,000 GPs in Clinical Commissioning Groups (CCGs). The crisis can be solved by spending the £3.8 bn pa of the Bette Care Fund (BCF) on better care Mindfulness Based Cognitive Therapy (MBCT) 8 week courses and supporting meditations for the city’s 10,000 vulnerable Rachels (65, depressed and in sheltered housing) and Dave (40, alcoholic and homeless) and provided with pooled budgets in Community Care Centres near every GP surgery.

2 Governing body seminar to find a solution to the ‘intractable nut’ of primary care.

3 Recommendations.

4 What is the HWB supposed to do?.

5 Who is hierarchically responsible and accountable for the spending of the £350 mpa CCG budget?

6 Why is this contentious?

7 Consequences of the power vacuum around the CCG.

8 What should the HWB do to fulfil this responsibility?

9 Prerequisite for an innovative solution – an open mind to think outside the box

10 What would a new mental health service for Rachel and Dave look like?

11 What is meant by the word ‘co-commissioning’?

12 Employment conditions.

13 What is the scale of the problem of over-prescribing?

14 How would 100 MBCT facilitators be recruited?

15 How would the proposed trial be conducted?

16 Is anyone else saying what SECTCo is saying?

17 Is any other CCG doing ‘co-production’, as SECTCo is proposing?

18 The new IAPT ‘better care’ should be MBCT rather than CBT.

19 Conclusion. Please implement the recommendations in paragraph 3 above.

20 References

Appendix 1 The sorry state of NHS provision of psychological therapy.
By Paul Atkinson March 2014

Appendix 2 Managing bipolar without medication
The Conversation 15.10.15

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