To:      Executive

26 April 2022



Overview and Scrutiny Review of Mental HealthReport

Councillor Gibson, Chair Health and Care Overview and Scrutiny Panel

1          Purpose of Report

1.1       To present the Executive with the findings of the Health and Care Overview and Scrutiny Panel’s review into primary care and voluntary sector mental health services which have been endorsed by the Overview & Scrutiny Commission, and to seek approval of the Panel’s recommendations.

1.2       To provide the advice of the Statutory Scrutiny Officer (SSO) to inform the Executive’s decision whether to agree the Panel’s recommendations.

2          Recommendations

2.1       That the Executive notes recommendations 1-4, made to the Health and Wellbeing Board and set out in paragraph 5.7 of this report.

2.2         That the Executive Member for Adult Services, Health and Housing invites the Chair of the Health and Care O&S Panel to present the mental health review report to the Health and Wellbeing Board on 7 June 2022.


2.3         That the Executive notes the recommendations made to Frimley Clinical Commissioning Group and set out in paragraph 5.8 of this report.


2.4         That the Executive Member for Adult Services, Health and Housing works with primary care and voluntary sector providers to increase the opportunity for mental health services to be present in community spaces. By December 2022, subject to the prevailing COVID approach.

3          Reasons for Recommendation

3.1       The Health and Care Overview and Scrutiny Panel concluded their findings based on the evidence considered and review that was undertaken. The review report is attached as Appendix A.

3.2       The Overview and Scrutiny Commission has endorsed the review recommendations, taking into account the review report and the views of the Statutory Scrutiny Officer.

3.3       The Statutory Scrutiny Officer concluded that this review activity had adequate resources and that mental health partners contributed effectively to the review.

3.4       The comments from the relevant officers and partners set out in paragraphs 7 – 9 of this report do not indicate any concerns with the proposed recommendations.

4          Alternative Options

4.1       The Executive could decide:

·         to agree the recommendations as set out in the Panel’s report

·         to agree the recommendation in part

·         to ask for further work to be undertaken recognising that this would delay the Panel’s next piece of work

·         to note the Panel report

5          Supporting Information from the Statutory Scrutiny Officer

5.1       It is the role of the SSO to advise the Council on any issues or concerns that may arise about the operation of the scrutiny function and the SSO may on occasion be required to make a determination about what the law says and how this should be applied to any particular situation.  In carrying out this statutory role, there is a need to have a nuanced and meaningful understanding of the scrutiny function in order to accurately make judgments about its operation when disagreements or other issues arise.

5.2       The SSO is responsible for ensuring that the scrutiny function is adequately resourced and that service departments and partners are contributing sufficiently to reviews to ensure that they are effective.

5.3       The SSO is also responsible for providing advice to the Commission and Executive on whether the recommendations within review reports are robust, taking account of resource, legal, climate change, equalities, health and wellbeing and strategic risk implications.

5.4       The Overview and Scrutiny Commission commissioned the Health and Care Overview and Scrutiny Panel to carry out a review into mental health services as part of the overview and scrutiny four-year work programme, which has been developed to track themes within the new Council Plan.

5.5       In support of this review, a broad range of witnesses gave evidence putting the Panel in a good position to use this intelligence to frame the review and produce insightful recommendations.

5.6       The Panel was supported by Jen Lawson, Governance and Scrutiny Officer who supported the Panel to draw up the scope of the review and prepare an evidence pack of relevant information; to facilitate a number of Panel sessions to interview a range of contributors; to draw out findings from the Panel’s investigation, and to prepare a review report.  This involved in the region of 300 hours of scrutiny officer time and 16 hours of Panel meetings. 

5.7       The draft Health and Wellbeing Strategy includes priorities on mental health and on creating opportunities for individual and community connections. Four of the Panel’s recommendations support these priorities and are made directly to the Health and Wellbeing Board for inclusion in the strategy action plans, with timescales to align with the action plan. The recommendations are:


1.         That the Health and Wellbeing Board consider the following points under the action to explore the development of a public facing marketing and communication campaign to raise awareness of services available and how to access them: 

·      Help people to understand each service to remove the fear of the unknown

·      Create personal connections which encourage engagement, such as using photos and first person accounts in communications

·      Include people with experience of the service as ambassadors to increase personal connections

·      Use outreach work to bring the service to the community

·      Emphasise the ability to self-refer and that there is no right or wrong ‘front door’

·      Demonstrate how people can direct their own care and recovery, making choices about their mental health

·      Use accessible language so people understand the approach and feel included

·      Include campaign information in councillor induction so councillors can signpost


2.         That the Health and Wellbeing Board ensures users are involved in the action to create and relaunch an improved version of the community map.  


3.         That the Health and Wellbeing Board ensures the community map training for providers supports collaboration between services, in particular between GPs/practice staff and the voluntary sector, to help them understand each other’s work and improve signposting and referrals.  


4.         That the Health and Wellbeing Board includes an event as part of the relaunch of the community map, to provide an opportunity to engage with the public to explain services and make connections.

5.8       The Commission considered the recommendations which were outside the draft Health and Wellbeing Strategy and endorsed two for referral to the Frimley Clinical Commissioning Group (CCG), to be made directly to the Director for Mental Health, Frimley CCG. The recommendations are:

That Frimley Clinical Commissioning Group (CCG) seeks agreement with primary care to clearly signpost mental health support on all GP websites. Target date for Bracknell to be confirmed by Frimley CCG.   


That Frimley CCG shares the findings of Talking Therapies’ work on low access rates from culturally and ethnically diverse communities and older adults with relevant health partners and voluntary and community groups. Target date to be confirmed by Frimley CCG.                                                 

5.9       In endorsing the Panel’s recommendations the Commission also took account of the Statutory Scrutiny Officer’s views. In summary, these were that this review activity had adequate resources and that mental health partners contributed effectively to the review. The bulk of review activity took place between October 2021 and January 2022 and the review was completed within the timescales agreed by the Commission when the review work was commissioned.  The comments from the relevant officers and partners set out below do not indicate any concerns with the proposed recommendations.

6          Commentary from Health and Care Overview and Scrutiny Panel Chair, Councillor Mike Gibson

6.1       The Bracknell Forest COVID Community Impact Assessment of July 2021 highlighted that many residents felt their mental health was worsening. Partners also shared concerns about the increasing prevalence and complexity of mental health needs in the borough, and a survey by Healthwatch Bracknell Forest identified mental health services as a particular priority for local health leaders.

6.2       In response, the Health and Care Panel carried out this review into mental health services to understand the impacts of the pandemic, and to find out what healthcare partners were experiencing and how they were responding. The review focused on primary care and the voluntary and community sector, recognising that self-help and prevention are the best ways to support the largest number of people in the shortest period of time. As well as services, the Panel heard from residents with a range of  experiences to ensure that the voice of local people regarding their needs was heard.

6.3       The review found a large variety of services in the borough with different ways of accessing them, including self-referral. The recommendations focus on increasing engagement and removing barriers to self-referral. The Panel listened to the experience of residents to identify practical actions that the council and our partners can take to help people access support.

7          Response from Director for Mental Health: Frimley Clinical Commissioning Group

7.1       The findings chime with the CCG’s experience, and we will look to build on them and work with partners to increase access and self-referral. These have been discussed with Fiona Slevin-Brown as the Managing Director of Bracknell Forest and we are supportive of the recommendations which align with many of our approaches. Frimley CCG will work with our system partners in primary care on which information is included on their websites and with Talking Therapies on the most appropriate way to disseminate their findings. At this stage we believe this can be achieved within the existing mental health budgets.


8          Response from Interim Consultant in Public Health


8.1       Public Health notes that the review findings align with their work and recognises the         cross-activity support for the Health & Wellbeing Strategy. This independent review is    further evidence that the proposals will directly improve population mental health and           wellbeing in Bracknell Forest.


8.2       The public health recommendations will be delivered within the Public Health Grant          allocation to Bracknell Forest Council.



9          Response from Assistant Director: Mental Health and Out of Hours


9.1       Bracknell Forest council works with the local NHS and other partners to meet the needs of people who need support with their mental health. The council does not     provide primary care, which was the focus of this review, but we have been involved     in the process and are comfortable with the approach taken. The review findings            align with our experience of providing secondary care support for more complex             needs. Improved access to self-care and early intervention will prevent some people        escalating to secondary care support, and we support the review recommendations       for their positive effect on local residents.


10        Consultation and Other Considerations

Legal Advice

10.1     There are no specific legal implications arising from the recommendations in this report.

Financial Advice

10.2     Any actions arising from the recommendations are expected to be delivered within existing budgets.

Equalities Impact Assessment

10.3     The review scope, activities and recommendations were all considered in the initial equalities screening attached at Appendix B.

Strategic Risk Management Issues

10.4     The draft Bracknell Forest Health and Wellbeing Strategy 2022 - 2026 is being finalised. It includes strategic priorities on mental health and on strengthening communities. These objectives are supported by the findings of this independent scrutiny review, which confirms the relevance and direction of the local mental health strategy over the next four years.

Climate Change Implications

10.5     The recommendations in the Panel report are expected to have a small positive impact on emissions of CO2.The recommendation to make use of shared community spaces on occasion should slightly reduce the need for heating and lighting of separate spaces. Any events are expected to be organised in line with the council’s climate change approach and delivered in a sustainable way.

Health & Wellbeing Considerations

10.6     The recommendations in the Panel report are designed to improve health and      wellbeing by increasing access to primary care mental health services.


Background Papers




Contact for further information

Kevin Gibbs, Statutory Scrutiny Officer - 01344 355621


Jen Lawson, Governance & Scrutiny Officer – 01344 353071