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Chief Executive’s Message – Friday 20 January

January 20, 2023

One of the many things I have been focusing on this week is our work in Ladywood & Perry Barr (West Birmingham). Colleagues will hopefully be aware that one of the key principles, enshrined in the Midland Met business case, is that of “postcode blind” services. What this essentially means, is that we aspire to ensure that any resident of either Birmingham or the Black Country, who will use the MMUH services, can do so safely supported by having the same or similar service offer from mental health services, adult social care or community services and teams. This principle is critical to making the service model and bed occupancy assumptions for the Midland Met, work from day one.

Recently, we have seen emerging evidence of some risks or issues developing on this principle, namely:

  • Birmingham residents having a longer length of stay compared to Sandwell residents using our hospital services, where once that was not the case
  • Sandwell Place Partnership developing a discharge model for patients with no criteria to reside (once described as our “medically fit” patients) that is different to that in Birmingham
  • Sandwell Place Partnership starting to develop attendance and admission avoidance services and measures, aligned to our winter plan and MMUH care model, that are different to those in Birmingham.

To an extent, this was always a risk and my predecessor, Toby Lewis, was very sighted on it. It drove our Board’s concern that, in the transfer of West Birmingham from the Black Country ICB to Birmingham & Solihull (BSol) ICB, that “Place” could get lost and service and financial investment differentials start to open up which would put our MMUH care model at risk.

Rather than accept these risks and allow them to play out, we have taken the view that the best thing we can do is to influence the service planning and alignment in Ladywood & Perry Barr by developing closer working relationships with other agencies in Birmingham. Improved transparency of information and more regular discussion has started to lead to improved awareness of our population’s needs and an acceptance that some changes need to be made in that part of the city, not just because of MMUH but also because of the deprived and diverse population of the area too. This week, the Trust Chair, Sir David Nicholson and I had a very productive meeting with our opposite numbers at Birmingham Community NHS FT. That Trust has been given the responsibility, as we have in Sandwell, to better integrate community, primary, social and mental health services in all of the Birmingham localities. We agreed the following key things, which should pave the way to minimising any postcode differentials in the future:

  • We will co-lead a pilot of the community integrator approach and the development of neighbourhood teams, in West Birmingham
  • We will work on receiving in-reach services to our hospital in the form of an “integrated front door” to avoid admission wherever possible
  • Birmingham Community Trust will help us to extract service matching commitments from mental health providers in Birmingham
  • We will develop urgent community response and virtual ward services at greater pace, with them

That’s it from me this week. I hope you are all well and have a good week.