24 April 2018 Andy Wright, IAPT Advisor, Heather Stonebank, Lead - PowerPoint PPT Presentation

Yorkshire and the Humber Mental Health Network Senior PWP Network 24 April 2018 • Andy Wright, IAPT Advisor, Heather Stonebank, Lead PWP Advisor and Sarah Boul, Quality Improvement Manager • andywright1@nhs.net, heather.stonebank@shsc.nhs.uk and sarah.boul@nhs.net • Twitter: @YHSCN_MHDN #yhmentalhealth • April 2018 www.england.nhs.uk

Housekeeping: @YHSCN_MHDN #yhmentalhealth www.england.nhs.uk

Yorkshire and the Humber Senior PWP Network Welcome, Introductions and Apologies Andy Wright, IAPT Advisor, Yorkshire and the Humber Clinical Network www.england.nhs.uk

Yorkshire and the Humber Senior PWP Network Raising Self-Awareness and Wellbeing All www.england.nhs.uk

Raising Self-Awareness and Wellbeing www.england.nhs.uk

Raising Self-Awareness and Wellbeing Happiness Life Approach Since January 2018 plot your emotional highs and lows – things, situations, people that had an impact. What was the situation? How did you feel at the time? www.england.nhs.uk

Raising Self-Awareness and Wellbeing • With the person next to you talk through your life line. • What did you learn from those experiences? • Were there any patterns or themes? • How are you going to take that learning positively into the future? www.england.nhs.uk

Raising Self-Awareness and Wellbeing Choose your future! Challenges and difficulties will happen. It is about how you respond/react www.england.nhs.uk

Yorkshire and the Humber Senior PWP Network Time for a break? 15 minutes only please! www.england.nhs.uk

Yorkshire and the Humber Senior PWP Network Provider Presentation: York and Selby Improving Access to Psychological Therapies Service Jasmine Turnbull and Lorraine Fourie, Senior PWPS, York and Selby IAPT www.england.nhs.uk

York and Selby IAPT Service Jasmine Turnbull and Lorraine Fourie Senior PWPs

Who we are:  Part of Tees, Esk and Wear Valleys NHS as of October 2015

We cover:  York  Selby  Easingwold  Tadcaster  Pocklington Population upwards of 351,000 Commissioned by the Vale of York CCG

Vale of York  Mainly rural aside from York city centre with small market towns  Generally affluent area  Small pockets of deprivation  Higher proportion of 20-24 year old due to the two universities  Higher percentage of the population than the national average is aged 50+

What happened in 2017 Lots of changes in the service:  Long waiting times for clients  Involvement of IST  Development of ‘Interim Pathway’ - combination of 1-1 sessions and psychoeducational course sessions for clients  Pathway in place for all modalities: PWP, CBT, Counselling New Pathway then developed:  Wellbeing Course first intervention to be offered for all clients aside from exceptions:  PTSD, social anxiety, under 18’s, communication difficulties

Development of the Wellbeing Course in 2017 Lots of changes in the service  Previously 3 groups  Stress Control (Jim White)  Improve your mood (BA group)  GAD (Dugas model) interactive group 2hrs in length  All 6 weeks and lecture style format with some group involvement  Evaluated groups and decided to continue due to recovery and attendance rates  Problems: Staff sickness, annual leave and shortness of staff

Wellbeing Course 2017  Rolling course - clients could start at any point  8 weeks in duration (Minimum of 6 to be attended)  Made it difficult to monitor attendance  Large course numbers (70)  Low rate of response for reviews  Clinicians felt improvements could be made & the course condensed – concerns about accessibility of an 8 week course for clients  No data due to incorrect tracking and PARIS input

Rapid Process Improvement Workshop (RPIW) November 2017  Aims to improve the process of clients accessing the service  Focus on the Wellbeing Course as the main point of entry for most  Courses had a start and end date for monitoring purposes – although no gaps in delivery for 2 week target  Evening course provided to improve access  Course workbook developed  Feedback forms improved for effective monitoring  Risk management protocol discussed in detail  Clients at higher risk of suicide or self harm now an exception for the course

Wellbeing course 2018  6 week course 3 groups run simultaneously (One evening and two day - 2 week’s apart) 1 hour sessions  Introduction to CBT and Goal setting  Understanding Anxiety and Lifestyle Factors  How our Behaviours Affect our Wellbeing  Thought Challenging and Worry Management  Relaxation and Sleep  Maintaining Progress and Review  Clients offered a review of therapy after session 6

Data from group  Day groups  Average 48 people on register before start and 38 attending  31.5% recovery rate  59% reliable improvement  Evening groups  65 people on the register before start and 44 people attending  38% recovery rate  62% reliable improvement

Data from group  Similarities of groups  20-25% drop out/cancelled before sessions started  70-75% completion rate  25-28% drop out rate during the group  25-30% of people accepted reviews after course  Of those people 20-30% were stepped up for further treatment  77% of attendees scored Moderate – Severe for GAD 7 at start of group  51% of attendees scored Moderate – Severe for PHQ 9 at start of group

Data from group  Positives:  Drop out rate low  Feedback from clients consistent with Data for attendance rates  Completed treatment rate high and people being stepped up is low  Positive changes can be made from data  Negatives:  Inconsistent data capture  Reason for discharge  Lack of admin support  Missing data values  No current theme or significant correlation between groups

Feedback from service users  It conceptualised my situation, put it into words and made me feel less alone/isolated  Really grateful for this course and being able to get on it so quickly when I was in a very dark place  The course has been really well presented and I’ve looked forward to attending. All of the presenters are very knowledgeable and empathetic  Still think it’s such a shame that our ideas are not shared in the session. I feel talking and sharing is so important in mental health but I understand that some people would be uncomfortable to share! Loved today’s session though, very useful. I will definitely be challenging my thoughts from now on!  Informative but overwhelming

SWOT Analysis Strengths Weaknesses Recruitment – difficult location and university doesn’t Reasonably quick access for clients Evening course for those who work full time offer training in York Amazing team PARIS New senior management Backlog pathway and transition to new pathway Retaining staff Trainee placements New groups (Step 2 and 3) Treatment choices Same building as other services Opportunities Threats New pathways (LTC, perinatal, students) Newly qualified staff team Development of groups Access rates Self-referral platform Agency staff (remote working and training needs) Website

Thank you for listening! Any Questions?

 http://www.valeofyorkccg.nhs.uk/about-us/about-the-ccg/  http://www.valeofyorkccg.nhs.uk/about-us/about-the-vale-of-york/

Yorkshire and the Humber Senior PWP Network Time for some lunch? www.england.nhs.uk

Yorkshire and the Humber Senior PWP Network IAPT LTC Service Presentation Liz Ruth, Senior PWP, Sheffield IAPT www.england.nhs.uk

Sheffield’s Integrated IAPT Team

Sheffield – a diverse city • pop: 575,400 (2016) • 19% BME communities – Caribbean, Indian, Bangladeshi, Somali, Yemeni, Eritrean and Chinese • ‘City of sanctuary’ • Student population • Variation in depravation • NHS in Sheffield

IAPT in Sheffield • Established in 2008 • Working in GP practices and community venues • Across 4 sector teams • Achieves 18% access target – rising to 23% in 2018 • Front line interventions  Improving Wellbeing Sessions  Stress Control  cCBT (Silvercloud)

Five Year Forward View for Mental Health IAPT Expansion Integration 1.5 million Top-up Evidence-base training people 2/3rds of this By 2020/21 National Top-up Maintaining expansion – 1.5 million training curriculum integrity to the key integrating physical people underway for characteristics of and mental health: PWPs and CBT – entering IAPT and development of treatment in for LTC/MUS implementing Integrated IAPT IAPT national guidance

Sheffield IAPT-LTC Early Implementer Wave 2 Site Building on Ambitious Pathway Establish new Pathfinder with bid approach service additional investment Ambitious Whole pathway Establishment of a and approach to Health and Wellbeing NHSE transformati LTC/MUS from Service: integrating investment & onal bid to Step1-Step 4: with primary care CCG create health and medical commitment systemic psychology to recurrent change funding