Plan to merge north London mental health trusts

North London NHS mental health bosses have given an update on new initiatives and a planned merger of trusts amid criticism over accessibility from the voluntary sector.

Jess Lievesley, an executive director at both Barnet, Enfield and Haringey Mental Health (BEH) NHS Trust and Camden and Islington (C&I) NHS Foundation Trust, told a meeting in Kentish Town on Monday 18 March how community services were being transformed across the five boroughs.

Speaking at the joint health overview and scrutiny committee for the North Central London NHS area, Lievesley said they were going through the process of merging the two trusts to form a single new mental health partnership by October.

Currently, both trusts make up the North London Mental Health Partnership (NLMHP), but the executive director said the formal merger of the two trusts would bring a “whole raft of benefits” with a “consistent and standard” between the boroughs.

Lievesley mentioned NLMHP’s new Highgate East building for mental health inpatients, which is opening at the end of March on a site in Dartmouth Park Hill and will be replacing corresponding facilities at St Pancras Hospital.

Highgate East contains 78 single ensuite rooms, outdoor space, therapy spaces, a sports hall and community cafe. Lievesley said it will be the “best inpatient unit in London”.

He also discussed how his team was aiming to “standardise and improve pathways” which were currently “too complicated” and that navigating them could be a “nightmare” — particularly in Camden and Islington where the teams are “smaller” and “more fragmented”.

He added patients wanted to have “one conversation with someone who identifies what their needs are, and for that pathway to work”.

“At the moment it is easier to access mental health services through the front door accident and emergency departments or by phoning the police than it is by contacting mental health services and that is just nonsensical, so we’ve got to turn that on its head.”

One of the new mental health initiatives that will happen in April is the new “111 press 2” helpline for people who need urgent support. This year a “single point of access” will also be set up for general “crisis response support” so residents get the same response wherever they live in North London.

The meeting also heard some criticisms of existing NHS mental health services.

Sonja Camara, the project manager at Sewn Together, a Haringey-based community group aiming to bolster community connections through crafts, said the information given about accessibility was “misleading”. She said there was “no point of access” to the services and if they were dealing with someone in a crisis there was “nowhere to go”.

This was a challenge as she said a lot of the group’s volunteers were not qualified to deal with certain levels of medical challenges. 

Camara said they felt “stuck” as they’d built up trust with individuals and sometimes needed to make referrals but the pathway “didn’t exist”. She said: “It’s usually a lot of phone calls, a lot of ‘no it’s not my department’ [and] ‘this service is no longer here’.”

She added that a lot of the mental health services were still not “racially appropriate” and said she could not see how the service was dealing with this.

“There’s still not enough representation for people that need the services from certain groups, whether that be language, culture, it’s not there. We’re literally exposing people to danger.”

In response, Lievesley said that in terms of accessing services for individuals in a crisis, it could be done through the NLMHP, NHS 111, or the crisis line. 

But he agreed some of the services were not able to target and access community groups that were “fearful or reticent to come forward”. 

Lievesley said they’d had “success” engaging with voluntary partners in a go-between role and added statutory services were not always well equipped to make connections and some practices of the past had put people off.

He said they’d updated the Metropolitan Police dedicated phone line’s “136 hub” so officers could better access mental health services for individuals who were detained or at risk of being detained under section 136 of the Mental Health Act. 

Camara responded saying she believed for the people who had to use the services it would still be “exactly the same”.

Ruth Glover, a director and consultant child and adolescent psychotherapist at Open Door, a voluntary sector service based in Haringey, also made a plea for access to be taken seriously as referrals were a “challenge”. 

She said there had been talks of increasing access in previous years and, combined with the lack of certainty brought on by short contract lengths, these factors had put staff under a lot of “stress”.

Committee member Cllr Pippa Connor agreed to make recommendations addressing issues around access and communication.

North Central London Joint Overview and Scrutiny Committee on Health – 18 March 2024.