Phil Sculthorpe

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(No Transcript)
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Phil Sculthorpe
A career history segueing through.

• Bedside nursing
• Hospital management
• Project management
• Planning/commissioning of health services
• Service improvement

3 abiding passions

• Improving performance through better
• measurement of need and delivery
• Wife 2 daughters
• Rock and roll

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Mental health some English perspectives
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England
N. Ireland (missing)
Gods country
Scotland (missing)
Wales (missing)
London (National Govt.)
New World (missing)
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Statistics
400 miles top to bottom 300 miles coast to coast
49.2 million people
87 of UK population
18 Black or ethnic minority
Health spend 8.3 GDP
Regional variations
150 local administrations
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Adults 16 74 years
4 psychotic disorder
16 neurotic disorder
8.6 suicides per 100,000
Hospital spend 4.6billion (13.1 of health spend)
Compulsory detention 88 per 100,000
Local gvt. Spend 815million (5.4 total PSS
spend)
11 detentions from the CJstce system
10 have used illicit drugs
Over 900,000 adults claim sickness benefit due to
mental health
26 report hazardous drinking pattern in last
year
Less than ¼ of adults with long term mh problem
in work
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The way forward

• Continue to build the science base
• Overcome stigma
• Improve public awareness of effective treatment
• Ensure the supply of mental health services and
  providers
• Ensure delivery of state-of-the-art treatments
• Tailor treatment to age, gender, race, and
  culture
• Facilitate entry into treatment
• Reduce financial barriers to treatment

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MH care systems
Nat Govt
Benefits
DoH
Other Depts
Home Office
Targets
Policy in relation to Education Social Services
Social Inclusion etc
Prisons
Local Authorities
Health Authority
commission
Social Services
PCTs
Schools
Trusts
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Health system
Nat Govt
Healthcare Commission
DoH
Targets
Inspection
Health Authority
Service improvement
Private not for profit sector
NIMHE
commission
PCTs
Trusts
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Key policy dates
1948 NHS created 1983 MH Act 1990 Community
Care 1991 Care Programme Approach 1994
Amendment to MH Act 1998 Community Care has
failed 1999 National Service Framework 2000
NHS Plan 2001 Modernisation Agency ? New MH
Act ? Payment by results
. Conservative administrations
. Labour administrations
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NIMHE
Regionally-based
Structured Positive Practice exchange
Local delivery within a national framework
System mediation
Policy review
Managed networks
Technical how to guidance
Collaboratives
Process mapping service redesign
Commissioner support
Service Mapping
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Primary care
¼ of routine GP appointments mh related
90 of mh care stays in primary care
30-50 depression unrecognised
New graduate workers
Primary care MH model Seemingly difficult to
articulate
Yet anti-depressant scripts increasing
GPs unable to prescribe Social care
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Hospital services
New service models
Av. LOS 18/19 days
Access
Av. Occupancy 91
Inpatient suicide
Gender issues
Dual diagnosis
Ethnicity issues
Staff issues
Restraint policies
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Social Inclusion
MH costs UK 77billion per year
Only 24 long term mh sufferers in work
75 of tabloid editorials about mh link it with
violence
Benefits trap
2/3 of young male suicides are unemployed
50 coverage uses highly stigmatising language
6 17,000 children care for an Adult with mh
problems
Public tolerance declining
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Mental health the judicial system
90 of prisoners have a mh problem
Secure provision rising
Dangerous People with Severe PD
30 have history of self-harm
Suicide x7 national average
Sexual predators
In-reach MH workers
Proposed new MH Act
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Care Services Improvement Partnership

• Commonalities
• Customers
• Carers
• Service provision

Build on NIMHE
Client specific programmes cross-client
programmes
Actively cross health and social care boundaries
Went live 1st April