Funding gap blamed for ‘painful’ closure of York mental health service which helped thousands

Health bosses have explained the reasons behind the abrupt closure of a service which was helping thousands of people with mental health problems in York.

Bosses at the Vale of York CCG (Clinical Commissioning Group) “deeply regret” the closure of the Primary Care Mental Health service last month – but said financial circumstances left them with no choice.

The service was launched in January to help people seeking mental health support from their GP.

A team of mental health specialists work at surgeries across York and in Elvington, Stamford Bridge, Strensall, Pocklington and Haxby.

They offered consultations and therapy to up to 6,000 patients a year.

Complex funding

The byzantine world of NHS finances led to the demise of the service.

It cost £310,000 a year. And the initial programme was paid for by a national NHS scheme.

This money was non-recurring. In a report to City of York Council’s health & adult social care policy & scrutiny committee, the CCG said they hoped to fund the service in future “through any cash savings delivered”.

But national changes to the GP contract saw the initial fund reallocated to another initiative which “left both the CCG and practices involved in an extremely difficult situation with an unexpected funding gap”.

“The only way the CCG could potentially have maintained funding to the service would have been to reduce funding to other commissioned services,” writes CCG director of primary care and population health Andrew Lee.

He adds:

• Consequently, due to the lack of onward funding, a very difficult decision was made by the practice for the service to be withdrawn.

  The closure of the service has inevitably created anger and frustration, both for patients as well as the general practices involved which is deeply regrettable.

Health system response

Mr Lee says the York health system, including GPs and the CCG, has worked together to help patients who were using the service find alternative support.

“This has included a careful examination of patients referred who are on the waiting list and triage to appropriate services.

“The patients were also advised to ring the Crisis and Access Service or attend A&E if they felt unsafe or at risk.”

The report says the service was set up in good faith to benefit patients. It states:

• This has been a difficult and painful experience for all stakeholders involved…

  The key lessons learned from this unfortunate incident is of the risks of establishing services using non-recurrent monies, as well as the difficulties created for patients and general practices when services are closed.

  The importance of sourcing sustainable funding for services is crucial and cannot be understated.

  The need for clearer communication between funder, service providers and patients is also clearly vital as there have been misunderstandings between the parties concerned that have not helped and undoubtedly affected trust and relationships that will need to be re-built.
  

The report concludes by saying that the CCG has increased support for mental health services in York with an additional £3.5 million of dedicated funding this year.

This investment has boosted Children and Young People’s Mental Health Services, allowed greater access to psychological therapies, and improved early intervention for individuals suffering from psychosis.