Three into one can go

To cut administration costs and release more resources to the front line three Sussex councils have brought together different mental health services. Simon Creasey reports

On 1 April, five new health care trusts came into being, the largest of which was the Sussex Partnership NHS Trust, which took over mental health, learning difficulties and addiction services for East Sussex, West Sussex and Brighton & Hove Councils.

The trust will serve 1.5 million people, have an annual spend of 250m and employ 4,500 staff. It was formed after a two-year public consultation and, on its launch, the management announced plans to release resources to boost specialist services and improve training and working conditions for front-line staff.

But is there a danger that centralisation will dilute resources and cause people in some parts of the region to miss out?

Not at all, says Lisa Rodrigues, the trust’s chief executive. Rodrigues – previously chief executive of East Sussex County Healthcare NHS Trust and West Sussex Health and Social Care NHS Trust – believes it will boost services and opportunities for staff.

She says: “We want to develop new services currently not provided in Sussex so that the money available provides care as close to home as possible. We want to achieve teaching trust status so that we can better support staff to develop their skills. We want to be the employer of choice for all staff from all disciplines so that we continue to recruit and train great people. And we want to challenge the stigma and discrimination that people using our services suffer from every day of their lives.”

To achieve these goals the trust has put in place a structure that allows local decision-making. Although the trust will be based in Worthing, it will continue to have offices in each of the three districts.

The difference now is that, whereas previously there were three boards for each of the these areas and three separate budgets for those boards, there is now just one board with three executive directors and one budget, which pools the resources.

Eradicating the need for three management boards – allied with other infrastructure changes – will halve the cost of funding the new trust compared with the three, according to Rodrigues.

“Previously, people had to go to London or further afield for specialist treatment so all of that money was going out of the region,” she says. “We thought ‘why not develop these services ourselves’ and our aspiration is to achieve this over the next five years.”

An important part of delivering these services will be the training links that have been established with local universities and the new Brighton and Sussex Medical School. Rodrigues says the trust will commission these bodies to provide education and training to its existing staff and in turn they will provide the trust with qualified doctors, nurses and psychiatrists of the future.

But questions have been raised about whether developing a centralised infrastructure could lead to some people receiving a diluted service. Rodrigues emphasises that the trust aims to “maintain a sensitivity to local issues and put in place a system that keeps us in touch with what is happening in the region”.

She adds that individual teams will continue to work where they do now with video conferencing used to prevent staff members having to travel around the region for meetings.

The only thing that will constantly move around the county is the trust’s 10 annual board meetings, which are open to the public. A further move could see the trust switch to new headquarters as Rodrigues says the current premises are too far to the west of the county.

However, the immediate target is to achieve all set-up costs in the first year and then start to release resources for front-line staff and services in the second year – a goal that Rodrigues is confident the trust will achieve.