SOUTH WEST AMBITIONS FOR MENTAL HEALTH AND LEARNING DISABILITIES

1
SOUTH WEST AMBITIONS FOR MENTAL HEALTH AND
LEARNING DISABILITIES

• South West Presentation 19 June 2009
• Dr Denise Cope MRCGP FRCPsych
• South West Lead for Mental Health

2

• How we got here?
• Ambitions for the South West for Mental Health
  and Wellbeing and Learning Disability
• The way forward

3
HOW WE GOT HERE

• Part of Next Stage NHS Review Process
• High Quality Care for All
• 10 regions
• 8 Clinical Pathway Groups
• - Maternity and New Born
• - Children and Young People
• - Staying Healthy
• - Acute Care
• - Planned Care
• - Long Term Conditions
• - Mental Health and Wellbeing
• - End of Life

4
HOW WE GOT HERE?

• High Quality Care for All

• Key Messages

• Quality

• care
• training
• workplaces
• leadership
• use of resources

5
Key Messages (continued)

• Safety
• Empowering patients / staff
• Innovation
• Local change

6
HOW WE GOT HERE

• Process began 21 November 2007
• 37 group members
• 3 Meetings
• Service user / Carer Day 80 participants
• Separate Learning Disability Day

• Draft Ambitions from Pathways Group (January 2008)

• South West Consultation (with over 2000
  consultees)

7
Strategic Framework for Improving Health in the
South West published 11/08
8
BEST PRACTICE FOR MENTAL HEALTH AND WELLBEING

• Non-discriminatory

• Integrated across all agencies, all settings

• Recovery focused

• Shared decision making

9
COMPONENTS OF GENERIC PATHWAY

• Health promotion, personal responsibility
• Information / signposting
• Early intervention
• Skilled practitioners
• Negotiated outcomes
• Informed choice
• Evidence based care
• Regular review and transition across boundaries

10
AMBITIONS FOR MENTAL HEALTH AND WELLBEING

• Full implementation of the standards set out in
  the National Service Framework for Mental Health
  by 31 December 2009

• Routine multidisciplinary assessments started
  within eight weeks by 31 March 2010 and within
  four weeks by 31 March 2011

11

• Assessments and initial care plans for the
  identified main carer started within four weeks
  of a service user assessment by 31 March 2010

• Adults with mild to moderate depression and
  anxiety to have access to psychological therapies
  in every Primary Care Trust by 31 March 2011.

• Specialist community-based eating disorder
  services by 31 March 2011

12

• People diagnosed with dementia to have an initial
  agreed care plan within four weeks of their
  diagnosis by 31 March 2010

• People receiving acute hospital care for physical
  conditions to have access to a full range of
  mental health liaison services by 31 March 2010

13

• People who have experience of serious mental
  illness and are discharged to primary care have a
  named worker in primary care to ensure rapid
  response and access to information and support by
  31 March 2010

• All Primary Care Trusts to use at least three
  best practice pathways, based on published
  guidelines from the National Institute for Health
  and Clinical Excellence and to incorporate
  service user-led outcomes in their commissioning
  requirements by 31 March 2011

14
EXAMPLES OF ADDITIONAL LOCAL ACTION

• Extend principle of early intervention to all
  services
• Focus on priorities of liaison, dementia,
  personality disorder, dual diagnosis
• Service user identified outcome measures
• Quality of inpatient services
• Clinical, service user and carer involvement in
  commissioning

15
BEST PRACTIC FOR LEARNING DISABILITY

• Non-discriminatory
• Facilitate independence
• Choice
• Inclusion

16
COMPONENTS OF EXCELLENT SERVICE

• Care co-ordination to ensure access to
  appropriate healthcare
• Engagement of service user and carer in
  decisions
• Timely assessment / intervention for service
  users and carers
• Focus on delivery of agreed outcomes

17
LEARNING DISABILITY AMBITIONS

• Full implementation of Valuing People a new
  strategy for learning disability for the 21st
  century

• 95 of general practices will be able to identify
  the people with a learning disability in the
  practice population by 31 March 2009

• Each person with a learning disability will have
  full access to the physical and mental health
  care they need.

18

• People with a learning disability will have the
  same access to screening services as everyone
  else.

• All people in NHS campus provision are to be
  housed in accommodation of their choice, with the
  appropriate level of care and support by 31 March
  2010

19
EXAMPLES OF ADDITIONAL LOCAL ACTION

• Maintain GP register of people with Learning
  Disability
• Provide accessible information
• Crisis and Home Treatment support for people with
  Learning Disability
• Improved training of all relevant NHS staff
• Effective partnerships to deliver consistent
  services

20
THE WAY FORWARD

• Re-Establishing Pathway Groups

• Separate Groups for Mental Health and Wellbeing
  and Learning Disability

• Performance monitoring of Strategic Ambitions by
  Strategic Health Authority

21
THE WAY FORWARD

• Terms of Reference Mental Health and Wellbeing
  Pathway Group

• Monitor progress against the ambitions of The
  Strategic Framework for Improving Health in the
  South West 2008/09 to 2010/11
• Identify areas of particular success and concern.
  Where there are areas of concern about delivery,
  to agree appropriate steps to ensure delivery
  (for example through clinical leadership)
• In the context of national and international
  evidence and developments, ensure commissioners
  can access up to date guidance on clinically
  effective patient pathways to improve patient
  experience and make best use of clinical resources

22
- Annually review the relevance and
appropriateness of the NHS South West ambitions
and recommend changes. There should be a
presumption in favour of accelerating
improvements rather than delaying them.
- Prepare a brief report, using a standard
template, for the South West Clinical Standing
Conference on progress with delivery, examples of
best practice, areas of concern, and any
proposals for amending the ambitions themselves
- Act as a reference group in the preparation
of annual review reports for presentation to
South West Strategic Health Authority
23
The Clinical Pathway Group for Mental Health and
Wellbeing shall lead and co-ordinate the
development of a regional strategy for mental
health and future ambitions, ensuring effective
engagement with stakeholders across the South
West. This work shall build on the forthcoming
national strategy, New Horizons for Mental Health
24
THE WAY FORWARD

• Membership of Group
• People with lived experience of using services,
  and supporting people who have mental health
  problems
• Clinicians and practitioners working within
  mental health services, and having a leadership
  role within those services
• Primary Care Trust and local authority mental
  health service commissioners drug and alcohol
  service commissioners and offenders health
  commissioners
• Local authority and Primary Care Trust directors
  of commissioning

25
THE WAY FORWARD

• Creative use of consultation methods
• website
• meetings
• individual Group members
• wider consultation with people with lived
  experience of service users and their carers

26

• Produce ongoing ambitious development plans for
  delivery of Mental Health and Wellbeing services,
  which are-
• - High Quality
• - Responsive to local need
• - Influenced by engagement with
  patients/carers and staff
• - Build on national strategy and evidence based
  practice.