Agenda and decisions

Salford City Council – Record of Decision

I, Councillor Gina Reynolds, Lead Member for Adult Services, Health & Wellbeing and co-chair of the Adults Commissioning Committee, in exercise of the powers contained within the City Council Constitution, do hereby approve:

Option 3 of the Adult Community Eating Disorders business case which details an increased capacity in the service to meet demand and align with CYP timescales (RTT urgent in 1 week or less, standard in 4 weeks or less). Costs for this option are £383,902 to meet 120 referrals and 110 treatment starts. This includes the £110k current funding and therefore the additional ask is £273,902 recurrently. These costs are indicative costs for approval and represent the maximum ask. The final financial ask is subject to negotiation with GMMH.

The reasons are:

The service is currently experiencing significant challenges due to a number of factors including:

·       Changes to NICE Guidance impacting on length of treatment

·       Concerns relating to the lack of medical input in the service and wider monitoring of people with ED in primary care

·       Changes to the use of day-patient services creating additional complexity within the community ED service

·       Increased identification of ED within specific cohorts (e.g. people with ASD and people with Type 1 Diabetes)

·       Changes to diagnostic criteria

·       Significant pressures on the service via sustained demand over and above the commissioned capacity

·       Mis-alignment between the new CYP access timescales and current ED service access times

·       Mis-alignment of treatment offers (e.g. family therapy) between CYP and ED services

The increased investment will support capacity to address demand, provide alignment to current CYP Eating Disorder community service timescales and provide additional interventions including:

·       Medical input (phlebotomy, interpretation and management of results, prescribing, support to primary care and acute hospital)

·       FREED – early intervention pathway for those people with first episode eating disorder

·       Family Therapy to align with CYP offer

·       SEED – severe and enduring eating disorder pathway

Options considered and rejected were:

·       Option 1: Do nothing

·       Option 2: Increase capacity in the service to meet demand and align with 18 week RTT timescales. Costs for this option are £335,030 to meet 120 referrals and 110 treatment starts. This includes the £110k current funding and therefore the additional ask is £225,030 recurrently.

Assessment of risk:

Without additional investment, the service will be unable to meet the stated demand to support a cohort of people known to have a significantly high mortality rate. Challenges relating to medical monitoring will not be resolved and the service will be unable to meet the anticipated waiting time standards.

The source of funding is: The Health and Care Integrated Fund 

Legal advice obtained: N/A

Financial advice obtained: David Warhurst (CFO Salford CCG) via Service & Finance Group

Procurement advice obtained: N/A

HR advice obtained: N/A

Climate change advice obtained: N/A

The following documents have been used to assist the decision-making process:

Adult Community Eating Disorders Business Case

Contact Officer:       Judd Skelton                    Tel no: 0161 212 5632                          

The appropriate scrutiny committee to call-in the decision is  ...  view the full decision text for item 5.

The meetings will all commence at 14:00 in the Salford Suite, Civic Centre, Chorley Road, Swinton, M27 5DA:

Wednesday 13 May 2020

Wednesday 10 June 2020

Wednesday 08 July 2020

Wednesday 09 September 2020

Wednesday 14 October 2020

Wednesday 11 November 2020

Wednesday 13 January 2021

Wednesday 10 February 2021

Wednesday 10 March 2021