Mental Health Integration Diagram *Interactive version For further information please contact: David Thomson NHS Quality Improvement Scotland. Mental Health Projects Manager, Directorate of Implementation, Improvement and Support &  National ICP Coordinator, Patient Safety and Performance Assessment Unit dthomson2@nhs.net

Mental Health Integration Diagram *Interactive version The following presentation is a PowerPoint based version of an interactive diagram which helps focus on where key drivers and work streams in mental health align, crossover and run parallel. The diagrams are generated from the developments and successful role out to mental health of ‘Releasing Time to Care’. These diagrams will evolve as services develop and progress towards excellence. This capacity for change reflects and promotes the principles of quality improvement and the necessity for on-going cycles of improvement as key. If you would like additional information to be added to the diagrams, please contact David Thomson - dthomson2@nhs.net

Quality Infrastructure A key requirement to realise our Quality Ambitions is for our systems and actions to be integrated and aligned across the whole NHS system. We need to identify and remove any hurdles and barriers presented by the current approaches to policy development and delivery across Scottish Government and NHSScotland. (The Healthcare Quality Strategy for NHSScotland, The Scottish Government, May 2010 ) By developing diagrammatic representations of key initiatives in mental health, it is intended that promoting better comprehension of integration contributes to removing obstacles to progress and further more, encourage increased confidence from individuals and organisations from all aspects of health care to participate and contribute to service improvement.

Rights, Relationships & Recovery Best Practice Statement Admissions to adult mental health inpatient services (BPS) HEAT Targets Mental Health Collaborative Tissue Viability Scottish Patient Safety Programme (SPSP) Clinical Quality Indicators (CQIs) Mental Health Act (MHA) Joanna Briggs Institute (JBI) Better Together/ Patient experience Healthcare Associated Infections (HAI) Falls Nutritional Care Scottish Recovery Indicator (SRI) Standards for integrated care pathways for mental health (ICP) Considerations to integration in mental Key areas of consideration. *It should be noted that this list is not exhaustive and may alter through time Releasing Time to Care (RTC) Rights, Relationships & Recovery Consider the 10 Essential Shared Capabilities for Mental Health Practice Click for further information on ESC Consider Leadership Click for information on leadership

Releasing Time to Care: Modular Content The Productive Mental Health Ward Modules: Patient Wellbeing Therapeutic Interventions Ward Round Safe and Supportive Observations Admissions and Discharges Shift Handover Meals Medicines Knowing How We’re Doing Well Organised Ward Patient Status at a Glance The Productive Mental Health: Community Hospital Admissions and Discharges Forward Planning MDT Working Handover Patient Flow Managing Drug Administration Good Stock Management Patient Involvement Clinical Leadership Knowing How We are Doing Click for examples of practice *All modular houses are underpinned with Project Leader’s and Executive Leader’s Guides

Productive Community Services Strategic Positioning Technology Team Leaders Guide Well Organised Working Environment Patient Perspective Knowing How We are Doing Patient Status at a Glance Toolkit Managing Caseload and Staffing Planning our Workload Working Better with Our Key Care Partners Agreeing the Care Plan with the Patient Standard Care Procedures Perfect Intervention *All modular houses are underpinned with Project Leader’s and Executive Leader’s Guides

Pre admission considerations RTC Community Services Click for RTC information Pre admission considerations Advanced statements and existing care plan MH(C&T)(S)A – Section 275 p216 Advance statements Click for MH(C&T)(S)ACT 2003 BPS Section 1(a,b,c,d) p8-12 Pre admission statement Click for BPS ICP P9 Referral and Triage Click for ICP Toolkit ICP P1-8 (Process Standards) Click for ICP toolkit Knowing How We’re Doing (RTC) Click for RTC information l Patient Status At a Glance (RTC) ICP 21 (Measures of need & outcome) ICP 11 (Risk assessment and management) Well Organised Ward (RTC) Key Points: Clear benefit from admission identified Consider all potential options to aid recovery Click to view improvement methodologies associated with Process Mapping Click for examples of practice

Best Practice Statement Considerations following admission to inpatient services ICP Standard 20 (Admission and Discharge Pathway) Click for ICP toolkit ICP Standards 10-17 (Generic Standards applicable to all e.g. Risk assessment, diagnosis. etc) Click her for ICP toolkit Best Practice Statement Admissions to adult mental health inpatient services (Risk assessment key points) (Section 2 – p13) Risk assessment and management plans (Subsections 2a-f) Exchange of information (Section 3 p20) Click for BPS RTC Process Modules Admissions and Discharge Click for RTC information HEAT Reduction of re-admissions Click here for information on HEAT Targets

Scottish Patient Safety Programme HEAT Reduction of suicide RTC Safe &Supportive Observations Click for RTC information BPS Section 2(f) (p19) (Risk assessment and management plans in relation to observation levels) & Section 4 (p27) (Assessment and planning for recovery) Click for BPS ICP Standards 10 (Holistic assessment) Click here for ICP toolkit 11 (Risk assessment) 17 (Single care plan) Click her for ICP toolkit HEAT Reduction of suicide Click here for information on HEAT Targets Scottish Patient Safety Programme Click here for information on the

& RTC Patient Wellbeing Falls ICP Standard 13(Physical Click for RTC information ICP Standard 13(Physical health assessment & management) Click here for ICP toolkit & 16 (Person centred care) BPS Section 5 (Holistic assessment: psychological /occupational /physical needs & strengths) Click for BPS Tissue viability click for tissue viability online Nutritional Care Click for information on nutritional care Pressure Area Care CQI Click for information on the CQI Food, fluid & nutrition Falls Click here for information on falls Falls CQI

ICP Scottish Patient Safety Programme RTC Medicines BPS Assessment and Click for RTC information BPS Assessment and Planning Recovery Section 3(e)p27 Click for BPS ICP Standard 18 (Recording Medications) Condition Specific Standards 15,16 &32 (considers medication monitoring) Click for ICP toolkit Scottish Patient Safety Programme Click here for information on the Click for information on improvement methodologies - LEAN

BPS ICP RTC Shift Handovers Section 2a (p15) Click for RTC information ICP Standards 7&38 (applying use of variance reporting and how information is conveyed) Click for ICP toolkit BPS Section 2a (p15) (conveyance of risk information) Section 2f (ensuring robust systems of communication) Click for BPS Consider principles of SBAR (Situation-Background- Assessment-Recommendation) Click here for information on SBAR

ICP RTC Therapeutic Interventions BPS Click for examples of practice Click for RTC information ICP Standard 15 (Psychological/Psychosocial interventions) Click here for ICP toolkit BPS Section 5 (p31) (Holistic assessment of psychosocial, occupational and physical needs and strengths) Click for BPS Click for examples of practice Consider the 10 Essential Shared Capabilities for Mental Health Practice Click for further information on ESC

RTC Meals Module ICP BPS Nutritional Care Tissue Viability Click for RTC information ICP Standard 13(Physical health assessment & management) Click here for ICP toolkit & 16 (Person centred care) BPS Section 5b (p33) (Guidance on physical needs assessment) Click for BPS Tissue Viability click for tissue viability online Nutritional Care Click for information on nutritional care Pressure Area Care CQI Click for information on the CQI Food, fluid & nutrition Also consider guidance within Health Facilities Scotland Click here for information on HFS Click here for information on improvement methodologies - PDSA

RTC Ward Round ICP BPS Consider principles of SBAR Click for RTC information ICP Standard 7 (Recording & sharing information) Click here for ICP toolkit & 17 (Single care plan) BPS Section 3 (p20) (Admission to hospital/exchange of information) Click for BPS Consider principles of SBAR (Situation-Background- Assessment-Recommendation) Click here for information on SBAR

RTC Community Services Pre and Post Discharge Considerations MHA Chapter 5 Section 227 (p82) Assessment of need for community care Chapter 7 (p122) Assessment of Need Click for MH(C&T)(S)ACT 2003 BPS Section 6 (p35) Pre/post discharge arrangements Section 4 (Measures of quality & experience) Click for BPS Scottish Recovery Indicators (Informing service improvements) Click for information on SRI/ ICP Standards 38 & 39 (Use of variance reporting to inform service improvements Click for ICP toolkit Consider quality measures and monitoring patient experience via for example ‘my view’ & SPSP SPSP Click here for information on the Scottish Patient Safety Programme Better Together Click here for information on patient experience RTC Admissions and Discharge Click for RTC information RTC Community Services Click for RTC information Click to hear about patient experiences Click for improvement tools re stories