Adult Mental Health Service Transformation Secondary Care redesign consultation

Overview Context for the countywide Adult Mental Health transformation programme New Enhanced Primary Care Service (“Worcestershire Healthy Minds”) Secondary Care co-production and emerging themes and consultation Next steps and timelines Sue

Context To meet all of the above we have to do Reducing budgets (2016/17 = 7.5%) Rising demand and expectations Need for earlier intervention/prevention Scale up self care and recovery More options /choice across the pathway To meet all of the above we have to do things differently, working collaboratively with partners

A new offer for the County: Wellbeing Hub Services that have been redesigned to provide easier and quicker access to assessment & treatment (including self referral and direct access to Talking Therapies the first for MH in Worcestershire) New ways of working with General Practice and the Voluntary and Community Sector to increase choice and access Provides countywide coverage and increasing options in local communities building on what people tell us they want A new offer for the County: Wellbeing Hub More choices (app, internet, talking therapies) More support in General Practice

Wellbeing Hub Managed by Community First and co-located with our clinical Single Point of Access (Professional Referral point) Self referral for Talking Therapies, signposting and community courses (Moodmaster) provided by; Onside, Inspire CiC, Simply Limitless, Stonham and Springfield Mind Peer support developments underway Seamless transition to secondary care where needed 550 self referrals to date – most contacts to date from Redditch and Worcester City.

Most viewed webpage on the public site WHM Website 10,546 April – August 2016 2nd Most viewed webpage on the public site

The Trust’s first self help app In house development of new Healthy Minds app Live on Android Google Play store on IOS app store Opportunities to develop further and align to long term conditions and our Patient Self Management Programme. 245 downloads to date The Trust’s first self help app

Secondary Care redesign: summary of the background… The services that need to be redesigned are: Community Mental Health Services Acute In Patient Wards Home Treatment Service. We have to offer inpatient and community services that are: Clinically effective Safe CQC compliant – environmental and quality of care standards Meeting commissioner and patient expectations Implemented within clear time lines Save money and work within the resources we have available

One year one - building the new model together 4 Co-Production ½ day Workshops – 120+ participants 4 Staff Engagement ½ day Workshops – 150+ participants Patient Forum Sense Check including Health Watch – 10 participants HOSC presentations – Autumn, December & January with monthly reports 4 x CMHT & Acute Care Pathway redesign ½ day workshops with managers & medics Monthly CCG clinical leads meeting with Commissioners Sue

Three Workshops – 5 recurring themes Reduce In Patient Acute Wards – facilities to be Centralised or provided North / South In Patient Wards with a clear function to provide: Intensive Triage / Assessment b) Treatment for the Acutely mentally ill Alternative provision in the form of locally available Crisis Beds or Safe Houses and Recovery / Rehab focussed Step Down. Increased & improved Home Treatment Team provision to care for more people in their own home Specialist Community Mental Health Teams with a clear function and remit to provide services to patients with serious mental illness Zelda

Key Principles Patients and carers have told us that what matters most to them are services that offer the following: Consistent staff who have time to listen and care Information – about services, treatment options, medication, diagnosis / prognosis, discharge Staff who involve patients and their families and carers and who work holistically Talking Therapies – not just medication Inpatient wards that offer activities and calm spaces and that are only used by those who really need them Zelda

Community Mental Health Teams We are proposing a Specialist Community Assessment & Recovery Service (CARS) that has been developed through: National Guidance - NICE, Royal College Psychiatrists, AIMS An in depth analysis of current staffing, role & function, caseloads and location. A further analyses of caseloads in order to identify any patients who could be offered new range of Primary Care Talking Therapies interventions (Worcestershire Healthy Minds). A review of the Gate Way Worker role to enhance Community Mental Health Team “step down and rapid access up” functions and liaison with GPs.

In Patient Wards Proposing an Intensive Assessment Ward (7 day admission) aligned with a separate Treatment Ward: Co production asked for separate wards as currently very unwell patients are mixed with those recovering and about to go home Clinically advised to separate the Intensive Assessment from the Treatment Ward A separate Assessment Ward needs a 1:2 ratio of Treatment beds Current estate can only support this if we use Holt 12 beds, Hillcrest 25 beds Develop alternatives to admission (i.e. safe houses, community personality disorder pathway, 24 hour supported living etc)

Next Steps… Taking the themes from Co Production into remodelling of the Acute Care Pathway & Community Mental Health & Recovery Teams Formal Consultation & further re modelling: July / September 2016 including: Wide distribution of consultation document, with Peer Support to enable completion Presentations at key meetings across the County Locality events Linking into partner networks Implement proposed new model – October / December 2016