Mental Health and Wellbeing Team Delivery Area 4 Hammersmith & Fulham CCG’s Patient Rep Group, 26 April 2017
Contents 1 - Like Minded overarching strategy Slide 3 2 - Achievements Slide 6 3 - Sustainability and Transformation Plan Slide 7 4 - Deep Dive into new Model of Care for adults with Serious and Long Term Mental Health Needs Slide 10 2
Like Minded overview: What is it? Like Minded is the strategy • Development is led by the NW for London Collaboration of CCGs. • Co-produced with service establishing users, carers, health & care professionals, third sector & joined up care user-led organisations and other experts. that leads to • Both Mental Health Trusts in excellent NW London actively involved in developing the strategy. mental health • Case for Change published August 2015 – describing a and wellbeing shared picture of the issues and our shared ambitions. outcomes • We are now working towards realising this vision. across North West London . Like Minded works across North West London – building on the local transformation and co-production work within each Borough, and on work led by our mental health providers 3
Like Minded: our shared vision for North West London Our vision is for North West London to be a place where people say: “My wellbeing and happiness is valued and I am supported to stay well and thrive” “As soon as I am struggling, appropriate and timely help is available” “The care and support I receive is joined -up, sensitive to my own needs, my personal beliefs, and delivered at the place that’s right for me and the people that matter to me” Core principles • My life is important, I am part of my community and I have opportunity, choice and control. • My wellbeing and mental health is valued equally to my physical health • I am seen as a whole person – professionals understand the impact of my housing situation, my networks, employment and income on my health and wellbeing • My care is seamless across different services, and in the most appropriate setting • I feel valued and supported to stay well for the whole of my life 4
Our Case for Change fed a number of existing workstreams – which have impact not jut in mental health sector Serious and Long Term Mental Health Needs Ensuring we address physical and mental health needs simultaneously and reduce use of A&E/acute hospitals Common Mental Health Needs Work with frail elderly and on Long Term Conditions needs to reflect depression and anxiety Children & Young People Specialist Eating Disorder services now provided across NW London, & CAMHS redesign underway - paediatric pathways link to CAMHS Perinatal Acute Recon & Maternity wards via new services in WLMHT areas Learning Disabilities Acute Recon, Local Services, via people moving out of acute beds and back into community in NW London Crisis Care Acute Recon, 7 Day Services & Local Services via Single Point of Access 24/7/365 for people needing crisis advice or referral Wellbeing and Prevention Links to Workforce, Local Services via work on Workplace Wellbeing Enablers for Mental Health Workforce, Outcomes, Estates links through all our workstreams 5
Transforming mental health services – work to date • Specialist Community Eating • Single Point of Access: A first • Specialist assessment, Disorder services for Children point of contact for people treatment and support for and Young People (aged 17 needing crisis advice or women in Ealing, Hounslow and under). referral. and Hammersmith & Fulham • Accepts referrals via Self, GPs, • Rapid Response Home with current or previous moderate to severe mental illness who are Schools/Colleges and other Treatment Team aims to pregnant or have given birth with professionals. provide 24/7/365 emergency the past year. • Brent, Harrow, Hillingdon, mental health care with the same • Accepts referrals from any urgency that people expect from Kensington & Chelsea and the NHS in a physical health professional including mental Westminster emergency. health professionals, midwives, Telephone: 020 3315 2711 • Over 2,250 calls were received obstetricians & GPs, and offers • Ealing, Hounslow, Hammersmith telephone advice to professionals and dealt with in the first 3 weeks & Fulham if they have concerns about a of service. Telephone: 020 8354 8160 woman’s mental health. • Brent, Harrow, Hillingdon, (CAMHS reception) • Around 50 referrals as of 7th April • West London Mental Health Trust Kensington & Chelsea and • Website: Westminster estimated demand in Year 1 is 70 Telephone: 0800 0234 650 www.wlmht.nhs.uk/service/peri cases. Email: cnw-tr.spa@nhs.net natal-mental-health-service • Ealing, Hounslow, Hammersmith & Fulham Telephone: 0300 1234 244 Children with Perinatal mental Crisis Response Eating Disorders health service 6
The North West London Sustainability and Transformation Plan (STP) Our Sustainability and Transformation Plan (STP) has 5 delivery areas, with delivery area 4 focusing on mental health. However Mental Health is referenced throughout the STP and threaded throughout our delivery areas – within prevention and within work on long term conditions. We know focus is required as poor mental health has catastrophic impacts for individuals – and also a wider social impact. Justice system, police stations, courts and prisons are all impacted by mental illness with social care supporting much of the care and financial burden for those with serious and long term mental health needs. The ‘5 Year Forward View for Mental Health’ describes how prevention, reducing stigma and early intervention are critical to reduce this impact – and the outcomes described in the implementation guidance are reflected in our plans. 7
The NW London Ambition: One of the aims for Delivery Area 1 , Improving Healthcare and Wellbeing, is to support people to stay healthy through targeted Supporting everybody to play their part in staying healthy work with the population who need mental health support. • Almost half the people claiming Employment Support Allowance have a mental health problem or behavioral difficulty. • An increasing prevalence of social isolation and loneliness is having a detrimental effect on health and well-being with 11% of the UK population reported to feel lonely all, most or more than half of the time. The NW London Ambition: Common Mental Health Needs falls under • Everyone in NW London has the same high Delivery Area 2 , Eliminating unwarranted quality care wherever they live variation and improving Long Term Condition • Every patient with an LTC has the chance to (LTC) management. become an expert in living with their condition • 146,000 people (estimation) have an LTC and a mental health problem, whether the mental health problem is diagnosed or not. • 317,000 people have a common mental illness and 46& of these are estimated to have an LTC. • Our aim is to recognise the linkage between LTCs and common mental illness, ensuring access to IAPT where needed to people living with or newly diagnosed with an LTC 8
Delivery Area 4 , Improving mental health services, is the focus of the Mental Health strategy in the STP. This is broken down into: • Implement the new model of care for people with serious and long term mental health needs, to improve physical, mental health and increase life expectancy • Focused interventions for target populations • Perinatal treatment • Transforming Care Plan for people with Learning Disabilities, Autism and challenging behaviours • Crisis support services delivering the ‘Crisis Care Concordat’ • Implementing ‘Future in Mind’ to improve children’s mental health and wellbeing 9
New Model of Care for Adults with Serious and Long Term Mental Health Needs Serious and Long Term Mental Health Needs (SLTMHN) is our biggest workstream within DA4. The new Model of Care for SLTMHN is developed based on optimum delivery for an overall population. • We believe that the successful implementation of the Model of Care (MoC) will deliver a range of benefits to service users, staff and the overall ‘system’ • At the heart of the MoC is the aim to support service users in the least intensive setting of care that is appropriate • Once the MoC is fully implemented we believe that the ‘shape’ of the system will be different to the current situation 10
Serious and Long Term Mental Health Needs • The Model of Care focuses on improvements to care in primary and community settings to support those with SLTMHN, intervene at the earliest stage possible where a crisis may be developing and provide ‘step down’ support from more intensive settings of care. As a result, we anticipate that acute inpatient bed use will reduce. • However, we recognise that for some people, the support provided by primary care, Recovery teams or crisis teams may not be sufficient for their needs and that an ‘alternative’ form of support to an acute inpatient bed would be more appropriate. • This area of the Model of Care is where we expect to see a significant shift in activity (from acute inpatient beds to ‘alternatives’) and where we anticipate a high level of investment. • Local ‘Health and Social Care Groups’ have been established to consider this part of the model and make recommendations on the types of ‘alternatives’ that may benefit from additional investment to support delivery of the Model of Care. 11
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