Download West CCG Locality Development Session

Discussion & Consultation Session
16th September 2015
Aims
•
To consider the proposed principles & outline
design to redesign of community based mental
health services as part of the implementation of
the Mental Health Framework.
•
To consult & gather feedback to inform the future
designs of the final proposed model
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The Mental Health Framework sets out a new direction in line with Five Year
Forward and has 5 agreed outcomes:
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Focus on keeping People Well
Mental Health & Physical Health Services are Better Integrated
Mental Health Services are Recovery & Outcome focused
Ensure access to high quality services informed by need
Challenge stigma & discrimination
Provider Partners have agreed that if we focus on the cross cutting themes
below we should rebalance the system towards Prevention, Effective Care,
Early Intervention & Recovery
 Information
 Crisis and Urgent Care
 Community Based Mental Health Services
 Children and Families
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Focus on keeping
people well – to
build resilience and
self-management
Mental health and
physical health
services will be
better integrated
Services will be
transformed to be
recovery and
outcome focussed
We will challenge
Stigma and
Discrimination
We will ensure
access to high
quality services
informed by need
We have many high quality & valued services but feedback from users
and providers also tell us that….

The system is incoherent, fragmented, diverse & often difficult to
navigate

Many people arrive in the ‘wrong place’ the first time as we assess for
service eligibility
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People often arrive at a crisis point rather than have earlier intervention

In primary care approximately 40% of people are signposted to another
service, including secondary care 1
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In secondary care approximately 30% of people are signposted to
another service including primary care 2
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Demand for services is unlikely to decrease and many communities are
becoming ever more diverse
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Widely different life expectancy depending on the area you live in
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Expenditure on mental health needs to be re-defined with more
partnership working
1, 2 Referral & Performance data 2014-15
4
Where have we started?
 Partner discussion & events from 2013 & 14
 Review of other cities, models and learned lessons
 Independence consultant commissioned to review &
outline high level design for consultation & coproduction
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Requirements of any new model
Information portal
Information and advice
Prevention & self management
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Primary Care Wrap around &
New Models of Care
24/7 access to advice and
guidance inc. psychiatrist,
pharmacist
Mental health long term
conditions and Liaison mental
health
Assessment Front Door
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Triage accessed via call centre
Crisis response & walk in
Tiered assessment same day
wherever possible
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Navigator service
Mental Health needs based pathways
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Centralised Information and selfhelp resources
Better use of universal services to
support the issues that many
service users face that relate to
housing, debt, employment
Principle of no wrong referral or
bounce back
Focus on early intervention
avoiding unnecessary pathways into
secondary care
Shifts some current secondary care
resource into primary care to “wrap
around” GPs and contribute to the
new models of care.
Uses cluster based standardised
assessment process reducing the
number of repeat assessments
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Project hosted by Mhabitat LYPFT
Public access for all - Mental Health Information site in
development by YOOMEE
Includes Public Health Branded Campaign Supporting
Prevention
Provides directions to the right places
Links to a simple referral process
Will have several phases of development
Question:
What would you find helpful?
How likely are you to use it?
Three things you would like to see?
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Questions:
What would you find helpful?
How
likely are you to use it?
Three
things you would like to see?
8
Simple points of access 24/7 for all mental health referrals
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No wrong door, One number, ‘one e-button’ via portal, no bounce
back & outcomes fed back to referrer
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Crisis & non crisis pathways
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Multi agency holistic triage
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Initial contact & assessment - same day offer
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Shared holistic assessment when needed- focussed by
needs/clusters/ Care Act Eligibility
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Stress management offer - as standard
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Continuity worker when needed during transitions
Questions:

What type of skill or resource would provide better outcomes for
people with mental health needs?
Examples might be access to additional voluntary service skills or
resource, direct referral access to specific services. access to multidisciplinary conversations i.e. pharmacist or psychologist,
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Questions:
 What type of skill or resource would provide
better outcomes for people with mental
health needs?
 Examples
might be access to additional
voluntary service skills or resource, direct
referral access to specific services. access to
multi-disciplinary conversations i.e.
psychiatrist, pharmacist or psychologist,
South Leeds - 23.09.15
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Enhancing primary care with New Models of Care with mental health
support
 Long term conditions – potential to develop current resource centres
provision into wider recovery college
 Expanding the roles of who can deliver Care Programme Approach
coordination & developing continuity workers
 More recovery & self management resource including peer support
 Examples of good practice
 Mental Health Liaison Clinicians in Integrated Neighbourhood Teams
 Mood Clinics- example in Canterbury.
 Shared Lives Support – host families for those in crisis
 Improved physical health, parity of esteem, supported depot
administration in primary care
Question:

What could enhanced primary care with mental health
support look like?
What opportunities do we have to test out new models?
What mental health resource could be provided?
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Questions:
 What could enhanced primary care with
mental health support look like?
 What
opportunities do we have to test out
new models?
 What
mental health resource could be
provided?
12
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Mental Health Clusters –“global description for groups of people with
similar characteristics, identified through holistic assessment & using
Mental Health Clustering Tool (MHCT)”. A payment by results system
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Broad high level ‘Super Clusters’ - Non Psychosis, Psychosis & Cognitive
Impairment drilled down & with levels of need/severity.
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Intervention designed by need with partnership pathways supporting the
wider determinants of health & need focussed on recovery, supported by
NICE Guidelines
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High level super clusters used in other health & social care trust focus
clinical discussions about referral, triage and screening decisions
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Intention to reduce variation & gaps in provision Right – person, place,
first time, skills
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Complex needs supported by specialist skills
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Examples of needs based pathways/ services, R & R Services, Aspire & in
Bristol & Wakefield
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Questions:
 Any examples of specific needs based
designs now?
 Are
there areas of unmet need that you
experience?
 What
kinds of needs based pathways could be
available?
 Anything
else?
14
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Information Hub
 What would you find helpful?
 How likely are you to use it?
 Three things you would like to see?

Single Point of Assessment
 What type of skill or resource would provide better outcomes for
people with mental health needs?
 Examples might be access to additional voluntary service skills or
resource, direct referral access to specific services. access to multidisciplinary conversations i.e. pharmacist or psychologist

Wrap around mental health services
 What would enhanced primary care mental health support look like?
 What opportunities do we have to test out new models?
 What mental health resource could be provided?
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Needs Based Pathway Design
 Any examples or specific needs based designs now?
 Are there areas of unmet need that you experience?
 What kinds of needs based pathways could be available?
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Jenny Thornton – Programme Manager
[email protected]
Jon Woolmer – Consultant for Design
Marrisa Carroll – Project Manager Community Based
Mental Health Re-design
[email protected]
Jeannette Lawson – Project Manager Urgent &
Unplanned Care- Crisis Care Concordat
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